Predictive Utility of the Glasgow Coma Scale and the Head Abbreviated Injury Scale in Traumatic Brain Injury: Results from the National Trauma Registry of Iran

Abstract

Background: Trauma severity indices are commonly used to describe the severity of sustained injuries in a quantitative manner perceivable by healthcare providers in different settings. In this study, we aimed to assess the predictive utility of the Glasgow Coma Scale (GCS) and the 2015 revision of the head Abbreviated Injury Scale (head AIS) as two of the most widely used severity indices for traumatic brain injury (TBI). Methods: In this cross-sectional study, we used data from the National Trauma Registry of Iran. The area under the receiver operating characteristic curve (AUROC) was calculated to assess the utility of GCS and head AIS scores in predicting patients’ outcomes. Results: A total of 321 patients, predominantly males (81.9%) with an average age of 41.9 (±19.5) years were enrolled in the study. The most common cause of injury was road traffic accidents (73.5%) followed by falls (20.2%). The mean admission GCS and head AIS scores were 13.5 (±3.2) and 2.5 (±1.0), respectively. AUROC of the GCS was significantly higher than the head AIS for all outcome variables (P<0.05). AUROC of both severity scoring systems for predicting in-hospital mortality was significantly higher in the 15–44 age group than the 65 or older age group (P<0.05). Conclusion: Based on our study results, GCS had better performance in predicting patients’ outcomes than the head AIS. Also, we found that age significantly affected the ability of these indices in predicting in-hospital mortality of TBI patients.