Is there a GOSE (Glasgow Outcome Scale Extended) score in cardiac anesthesia or cardiology?

GOSE Score in Cardiac Anesthesia and Cardiology

There is no specific GOSE (Glasgow Outcome Scale Extended) score designed for or routinely used in cardiac anesthesia or cardiology. The GOSE is primarily used in traumatic brain injury assessment, not for cardiac patients 1.

Understanding GOSE and Its Applications

The Glasgow Outcome Scale Extended (GOSE) is an 8-point scale that is:

• Primarily developed and validated for traumatic brain injury (TBI) patients 1
• Used to assess functional recovery and neurological outcomes after brain injury 1
• Commonly employed as a primary outcome measure in TBI clinical trials 2

GOSE Assessment Components

The GOSE evaluates:

• Independence in activities of daily living
• Return to work capabilities
• Social and leisure activities
• Personal relationships
• Ongoing symptoms that disrupt daily life

Alternative Assessment Tools in Cardiac Settings

For cardiac anesthesia and cardiology, different assessment tools are used instead:

1. Glasgow Coma Scale (GCS):

   • Has been studied in cardiac surgery patients but shown to have limitations
   • Research indicates GCS is not an accurate outcome predictor in cardiac surgical patients, regardless of sedation status 3
   • However, some studies suggest GCS monitoring can be useful for outcome prediction in cardiac arrest patients treated with therapeutic hypothermia 4

2. Modified Glasgow Outcome Score (MGOS):

   • A modified version developed specifically for cardiac arrest patients
   • Separates patients who died without certified brain damage from those with poor neurological outcomes
   • Shown to improve prognostic accuracy when using biomarkers like NSE and S100B 5

3. American College of Surgeons NSQIP Surgical Risk Calculator:

   • More commonly used for cardiac surgical risk assessment
   • Incorporates 21 patient-specific variables including age, sex, BMI, functional status, and comorbidities 6
   • Provides comprehensive risk estimates for multiple outcomes beyond just cardiac events 6

Clinical Implications

When assessing neurological outcomes in cardiac patients:

• For cardiac surgery patients: Standard GCS has poor reliability for outcome prediction 3
• For post-cardiac arrest patients: GCS motor score >3 on day 4 after cardiac arrest may indicate increased likelihood of favorable outcome (weak recommendation, very low-certainty evidence) 1
• For research purposes: If neurological assessment is needed in cardiac patients, consider using the Modified Glasgow Outcome Score (MGOS) which has been specifically adapted for cardiac arrest patients 5

Technological Advancements

Recent developments include:

• GOSE mobile applications that have been validated against traditional interview methods for TBI patients 7
• Methods to reduce misclassification in GOSE scoring through alternative rating systems and central quality control 2

However, these advancements remain focused on TBI patients rather than cardiac patients.

Conclusion

While the GOSE is a valuable tool in TBI assessment, cardiac anesthesia and cardiology rely on different scoring systems and risk calculators that are more appropriate for cardiovascular conditions. If neurological assessment is needed in cardiac patients, tools like the Modified Glasgow Outcome Score (MGOS) may be more appropriate than the standard GOSE.