Jennett and Bond proposed the first version of the Glasgow Outcome Scale in 1975, defining 5 categories of possible outcomes after a brain injury (1):
Glasgow Outcome Scale GOS
| Category number | Name | Definition |
|---|---|---|
| 5 | Good recovery | resumption of normal life (minor neurological or psychological deficits) |
| 4 | Moderate disability | disabled but independent for daily life; work capacity is reduced |
| 3 | Sever disability | conscious but dependent for daily life; unable to travel or go shopping without assistance |
| 2 | Persistent vegetative state | unresponsive and speechless |
| 1 | Death |
In most of the publications, authors refer to a number instead of the name of a given category (e.g. “GOS 3” instead of “Sever disability”). However, because the order of these categories varies across studies, the reader should be very cautious when interpreting these numbers and always check carefully the used referential.
In their first publication (1; but contrarily to the latter (2)), Jennett & Bond ordered the 5 categories that way.
Latter, the same authors proposed to split the 3 better categories (sever disability to good recovery or, 3 to 5 here) in Lower & Upper sub-categories, giving the extended version of the scale (the GOS-E) which include 6 + 2 (death and VS) = 8 categories (2).
Glasgow Outcome Scale Extended GOS-E
| Category number** | Name | Definition (see refs for more details) |
|---|---|---|
| 8 | Good recovery Upper | no current problems related to the brain injury that affect daily life |
| 7 | Good recovery Lower | minor problems that affect daily life; resumes >50% of the pre-injury level of social and leisure activities |
| 6 | Moderate disability Upper | reduced work capacity; resumes <50% of the pre-injury level of social and leisure activities |
| 5 | Moderate disability Lower | unable to work or only in sheltered workshop |
| 4 | Sever disability Upper | can be left alone > 8h during the day, but unable to travel and/or go shopping without assistance |
| 3 | Sever disability Lower | requires frequent help of someone to be around at home most of the time every day |
| 2 | Persistent vegetative state | unresponsive and speechless |
| 1 | Death |
** Here I voluntarily kept the same order as in the first table; note that most of recent publications use this order though, “the higher the number the better the outcome” but again, the reader should always check carefully the used referential!
Structured interview for the GOS and the GOS-E have been proposed (3) as well a useful comparative table with key criteria (4).
References:
- Jennett B, Bond M. Assessment of outcome after severe brain damage. Lancet. 1975 Mar 1;1(7905):480–4 (doi).
- Jennett B, Snoek J, Bond MR, Brooks N. Disability after severe head injury: observations on the use of the Glasgow Outcome Scale. J Neurol Neurosurg Psychiatry. 1981 Apr 1;44(4):285–93 (doi).
- Wilson J t. L, Pettigrew LE l., Teasdale GM. Structured Interviews for the Glasgow Outcome Scale and the Extended Glasgow Outcome Scale: Guidelines for Their Use. Journal of Neurotrauma. 1998 Aug 1;15(8):573–85 (doi).
- Lu J, Marmarou A, Lapane K, Turf E, Wilson L, IMPACT Group, et al. A method for reducing misclassification in the extended Glasgow Outcome Score. J Neurotrauma. 2010 May;27(5):843–52 (doi).