Abstract
Background:The Glasgow Coma Scale (GCS) is popular, simple, and reliable, and provides information about the level of consciousness in trauma patients. However, a systemic evaluation scale especially in patients with multiple traumas is so important. The revised Acute Physiology and Chronic Health Evaluation system type 2 (APACHE II) is a physiologically based system including physiological variables. This study compares the efficacy of the predicting power for mortality and functional outcome of GCS and APACHEII in patients with multiple traumas in intensive care unit.Methods:This study included the patients with head injury associated with systemic trauma admitted in the ICU of Shahid Rajaee Hospital in 2007 and 2008. Sensitivity, specificity and correct prediction of outcome by GCS and APACHE II were assessed and compared.Results:This study included 93 patients (79 males, 14 females; mean age 60.5; range 14 to 87 years) with head injury associated with systemic trauma in 2007 and 2008. Mortality increased in the elderly group. The mean survival score using APACHE II was 36.5 and death score was 67.4. These values using GCS were 10.3 and 6.8, respectively.Conclusion:For the assessment of mortality, the GCS score still provides simple, rapid and effective assessment in head injury patients, however, for the prediction of mortality in patients with multiple trauma APACHE II is superior to GCS since it includes multiple systemic parameters in these patients.
Highlights
A growing focus on health quality and mortality risk increased the need for accurate severity scoring systems in patients (Khuri, Daley, Henderson, et al, 1998)
There was no significant difference for sex in terms of mortality (p=0.459), mortality increased in the elderly group (p
It is known that a low Glasgow Coma Scale (GCS) is associated with poor prognosis; the measurement can be complicated in some cases
Summary
A growing focus on health quality and mortality risk increased the need for accurate severity scoring systems in patients (Khuri, Daley, Henderson, et al, 1998). This study compares the efficacy of the predicting power for mortality and functional outcome of GCS and APACHEII in patients with multiple traumas in intensive care unit. Methods: This study included the patients with head injury associated with systemic trauma admitted in the ICU of Shahid Rajaee Hospital in 2007 and 2008. Results: This study included 93 patients (79 males, 14 females; mean age 60.5; range 14 to 87 years) with head injury associated with systemic trauma in 2007 and 2008. Conclusion: For the assessment of mortality, the GCS score still provides simple, rapid and effective assessment in head injury patients, for the prediction of mortality in patients with multiple trauma APACHE II is superior to GCS since it includes multiple systemic parameters in these patients
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