Value of the Glasgow coma scale, age, and arterial blood pressure score for predicting the mortality of major trauma patients presenting to the emergency department

DÖNMEZ, Serdar Suha; AHUN, Erhan; armağan, erol; KÖKSAL, Özlem; Torun, Gökhan; Sigirli, Deniz

Value of the Glasgow coma scale, age, and arterial blood pressure score for predicting the mortality of major trauma patients presenting to the emergency department

Erhan AHUN, (Uludağ Üniversitesi, Tıp Fakültesi, Acil Tıp Anabilim Dalı, Bursa, Türkiye)

Özlem KÖKSAL, (Uludağ Üniversitesi, Tıp Fakültesi, Acil Tıp Anabilim Dalı, Bursa, Türkiye)

Deniz SIĞIRLI, (Uludağ Üniversitesi, Tıp Fakültesi, Biyoistatistik Anabilim Dalı, Bursa, Türkiye)

Gökhan TORUN, (Uludağ Üniversitesi, Tıp Fakültesi, Acil Tıp Anabilim Dalı, Bursa, Türkiye)

Serdar Suha DÖNMEZ, (Uludağ Üniversitesi, Tıp Fakültesi, Acil Tıp Anabilim Dalı, Bursa, Türkiye)

Erol ARMAĞAN (Uludağ Üniversitesi, Tıp Fakültesi, Acil Tıp Anabilim Dalı, Bursa, Türkiye)

Ulusal Travma ve Acil Cerrahi Dergisi

1 0

Yıl: 2014 Cilt: 20 Sayı: 4 Sayfa Aralığı: 241 - 247 Metin Dili: Türkçe İndeks Tarihi: 29-07-2022

Value of the Glasgow coma scale, age, and arterial blood pressure score for predicting the mortality of major trauma patients presenting to the emergency department

Öz:

AMAÇ: Bu çalışmanın amacı yeni bir travma skorlama sistemi olan GAP skorunun Acil Servis'e (AS) başvuran majör travma hastalarında mortalite tahmin gücünü değerlendirmektir. GEREÇ VE YÖNTEM: Uludağ Üniversitesi Tıp Fakültesi Hastanesi AS'ye başvuran >=18 yaş majör travmalı 100 hasta çalışmaya alındı. Hasta verileri ileriye yönelik olarak değerlendirilerek hastaların RTS, ISS, TRISS, MGAP ve GAP skorları hesaplandı. BULGULAR: Hastane içi mortaliteyi öngörmede, ISS, TRISS, MGAP ve GAP arasında pozitif yönde anlamlı bir korelasyon saptandı (p<0.0001). Travma skorlama sistemlerinin sırasıyla kısa dönem (24 saat) ve uzun dönem (4 hafta) mortalite tahmin oranları ROC analizinde Eğri Altındaki Alan (EAA)- Area Under Curve (AUC); RTS için 0.727- 0.680, ISS için 0.863-0.816, TRISS için 0.945-0.911 MGAP için 0.970-0.938, GAP için 0.910- 0.904 olarak bulundu. Hesaplanan travma skorlarının hepsinin mortalite tahmin gücü anlamlı olarak bulundu (p<0.001). GAP'ın hem AS'de, hem de hastane içi mortaliteyi öngörmede istatistiksel olarak anlamlı bir şekilde (p=0.0001) seçici ve duyarlı olduğu belirlendi. TARTIŞMA: Bu sonuçlarla GAP skorunun travma hastalarında, hem sahada ve hem de başvuru anında AS'de kolayca hesaplanabilecek ve hastanın mortalitesini öngörerek AS doktoruna fikir verebilecek bir skorlama sistemi olduğunu düşünmekteyiz. Anahtar sözcükler: Majör travma; mortalite; travma skorlama sistemleri.

Anahtar Kelime:

Konular: Cerrahi

Acil servise başvuran majör travma hastalarının mortalite tahmininde Glasgow koma skalası, yaş ve arteriyel kan basıncı skorunun değerliliği

Öz:

BACKGROUND: The purpose of this study is to detect the mortality predictive power of new Glasgow coma scale, age, and arterial pressure (GAP) scoring system in major trauma patients admitted to the emergency department (ED).METHODS: A total of 100 major trauma patients admitted to Uludağ University Faculty of Medicine ED who were 18 years of age or more were included in the study. In this prospective study, revised trauma score (RTS), injury severity score (ISS), trauma-related ISS (TRISS), Mechanism, GAP (MGAP) and GAP scores of the patients were calculated.RESULTS: A significant positive correlation was established between ISS, TRISS, MGAP, and GAP in predicting in-hospital mortality (p<0.0001). Short-term (24 hours) and long-term (4-week) mortality prediction rates and area under the curve in receiver operating characteristics analysis were 0.727-0.680 for RTS, 0.863-0.816 for ISS, 0.945-0,911 for TRISS, 0.970-0.938 for MGAP, and 0.910-0.904 for GAP. All calculated trauma scoring systems revealed a significant mortality prediction power (p<0.001). GAP score was found statistically and significantly selective and sensitive in predicting both in-ED and in-hospital mortality (p=0.0001).CONCLUSION: In major trauma patients, GAP score is an easily calculable system both in the field and at the time of admission in the EDs by providing emergency physicians with future decision-making schemes by means of mortality prediction of the patients

Anahtar Kelime:

Konular: Cerrahi

Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık

Hunt RC, Krohmer JR. American College of Surgeons Committee on Trauma. Advanced Trauma Life Support Program for Doctors. 7th ed, 2004. p. 1-10.
Lewis FR. Initial assessment and resuscitation. Emerg Med Clin North Am 1984;2:733-48.
Kirkpatrick JR, Youmans RL. Trauma index. An aide in the evaluation of injury victims. J Trauma 1971;11:711-4.
Kondo Y, Abe T, Kohshi K, Tokuda Y, Cook EF, Kukita I. Revised trau- ma scoring system to predict in-hospital mortality in the emergency de- partment: Glasgow Coma Scale, Age, and Systolic Blood Pressure score. Crit Care 2011;15:R191.
Sartorius D, Le Manach Y, David JS, Rancurel E, Smail N, Thicoïpé M, et al. Mechanism, glasgow coma scale, age, and arterial pressure (MGAP): a new simple prehospital triage score to predict mortality in trauma pa- tients. Crit Care Med 2010;38:831-7.
Llullaku SS, Hyseni NSh, Bytyçi CI, Rexhepi SK. Evaluation of trauma care using TRISS method: the role of adjusted misclassification rate and adjusted w-statistic. World J Emerg Surg 2009;4:2.
Joosse P, Soedarmo S, Luitse JS, Ponsen KJ. Trauma outcome analysis of a Jakarta University Hospital using the TRISS method: validation and limitation in comparison with the major trauma outcome study. Trauma and Injury Severity Score. J Trauma 2001;51:134-40.
Champion HR. Trauma scoring. Scand J Surg 2002;91:12-22.
Senkowski CK, McKenney MG. Trauma scoring systems: a review. J Am Coll Surg 1999;189:491-503.
Hargrove J, Nguyen HB. Bench-to-bedside review: outcome predic- tions for critically ill patients in the emergency department. Crit Care 2005;9:376-83.
Trunkey DD. Trauma. Accidental and intentional injuries account for more years of life lost in the U.S. than cancer and heart disease. Among the prescribed remedies are improved preventive efforts, speedier surgery and further research. Sci Am 1983;249:28-35.
Subbe CP, Slater A, Menon D, Gemmell L. Validation of physiological scoring systems in the accident and emergency department. Emerg Med J 2006;23:841-5.
Chawda MN, Hildebrand F, Pape HC, Giannoudis PV. Predicting out- come after multiple trauma: which scoring system? Injury 2004;35:347- 58.
Guenther S, Waydhas C, Ose C, Nast-Kolb D; Multiple Trauma Task Force, German Trauma Society. Quality of multiple trauma care in 33 German and Swiss trauma centers during a 5-year period: regular versus on-call service. J Trauma 2003;54:973-8.
Champion HR, Sacco WJ, Carnazzo AJ, Copes W, Fouty WJ. Trauma score. Crit Care Med 1981;9:672-6.

APA	AHUN E, KÖKSAL Ö, Sigirli D, Torun G, DÖNMEZ S, armağan e (2014). Value of the Glasgow coma scale, age, and arterial blood pressure score for predicting the mortality of major trauma patients presenting to the emergency department. , 241 - 247.
Chicago	AHUN Erhan,KÖKSAL Özlem,Sigirli Deniz,Torun Gökhan,DÖNMEZ Serdar Suha,armağan erol Value of the Glasgow coma scale, age, and arterial blood pressure score for predicting the mortality of major trauma patients presenting to the emergency department. (2014): 241 - 247.
MLA	AHUN Erhan,KÖKSAL Özlem,Sigirli Deniz,Torun Gökhan,DÖNMEZ Serdar Suha,armağan erol Value of the Glasgow coma scale, age, and arterial blood pressure score for predicting the mortality of major trauma patients presenting to the emergency department. , 2014, ss.241 - 247.
AMA	AHUN E,KÖKSAL Ö,Sigirli D,Torun G,DÖNMEZ S,armağan e Value of the Glasgow coma scale, age, and arterial blood pressure score for predicting the mortality of major trauma patients presenting to the emergency department. . 2014; 241 - 247.
Vancouver	AHUN E,KÖKSAL Ö,Sigirli D,Torun G,DÖNMEZ S,armağan e Value of the Glasgow coma scale, age, and arterial blood pressure score for predicting the mortality of major trauma patients presenting to the emergency department. . 2014; 241 - 247.
IEEE	AHUN E,KÖKSAL Ö,Sigirli D,Torun G,DÖNMEZ S,armağan e "Value of the Glasgow coma scale, age, and arterial blood pressure score for predicting the mortality of major trauma patients presenting to the emergency department." , ss.241 - 247, 2014.
ISNAD	AHUN, Erhan vd. "Value of the Glasgow coma scale, age, and arterial blood pressure score for predicting the mortality of major trauma patients presenting to the emergency department". (2014), 241-247.

APA	AHUN E, KÖKSAL Ö, Sigirli D, Torun G, DÖNMEZ S, armağan e (2014). Value of the Glasgow coma scale, age, and arterial blood pressure score for predicting the mortality of major trauma patients presenting to the emergency department. Ulusal Travma ve Acil Cerrahi Dergisi, 20(4), 241 - 247.
Chicago	AHUN Erhan,KÖKSAL Özlem,Sigirli Deniz,Torun Gökhan,DÖNMEZ Serdar Suha,armağan erol Value of the Glasgow coma scale, age, and arterial blood pressure score for predicting the mortality of major trauma patients presenting to the emergency department. Ulusal Travma ve Acil Cerrahi Dergisi 20, no.4 (2014): 241 - 247.
MLA	AHUN Erhan,KÖKSAL Özlem,Sigirli Deniz,Torun Gökhan,DÖNMEZ Serdar Suha,armağan erol Value of the Glasgow coma scale, age, and arterial blood pressure score for predicting the mortality of major trauma patients presenting to the emergency department. Ulusal Travma ve Acil Cerrahi Dergisi, vol.20, no.4, 2014, ss.241 - 247.
AMA	AHUN E,KÖKSAL Ö,Sigirli D,Torun G,DÖNMEZ S,armağan e Value of the Glasgow coma scale, age, and arterial blood pressure score for predicting the mortality of major trauma patients presenting to the emergency department. Ulusal Travma ve Acil Cerrahi Dergisi. 2014; 20(4): 241 - 247.
Vancouver	AHUN E,KÖKSAL Ö,Sigirli D,Torun G,DÖNMEZ S,armağan e Value of the Glasgow coma scale, age, and arterial blood pressure score for predicting the mortality of major trauma patients presenting to the emergency department. Ulusal Travma ve Acil Cerrahi Dergisi. 2014; 20(4): 241 - 247.
IEEE	AHUN E,KÖKSAL Ö,Sigirli D,Torun G,DÖNMEZ S,armağan e "Value of the Glasgow coma scale, age, and arterial blood pressure score for predicting the mortality of major trauma patients presenting to the emergency department." Ulusal Travma ve Acil Cerrahi Dergisi, 20, ss.241 - 247, 2014.
ISNAD	AHUN, Erhan vd. "Value of the Glasgow coma scale, age, and arterial blood pressure score for predicting the mortality of major trauma patients presenting to the emergency department". Ulusal Travma ve Acil Cerrahi Dergisi 20/4 (2014), 241-247.