Decreased Glasgow Coma Scale score in medical patients as an indicator for intubation in the Emergency Department: Why are we doing it?

Ribeiro, Sabrina Corrêa da Costa

doi:10.6061/clinics/2021/e2282

Cited by 2 publications

(2 citation statements)

References 17 publications

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“…Our study extended the concept of heterogeneity of patient groups to diagnostic categories and showed hidden relations with mortality in the subgroups. Studies suggested that to support the EI of patients with medical problems based on a GCS score, other factors such as disease trajectory, diagnosis, and prognosis, must be considered [ 10 ]. Again our study extended this concept to surgical patients.…”

Section: Discussionmentioning

confidence: 99%

“…al [ 7 ] reported that early EI was safe and effective in trauma patients and that the Eastern Association for the Surgery of Trauma Guidelines might miss patients who would benefit from EI early after injury. The clinical risk or advantages of EI in medical patients with a low GCS score has not been well established yet [ 7 , 9 , 10 ].…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Association of Glasgow coma scale and endotracheal intubation in predicting mortality among patients admitted to the intensive care unit

Markazi-Moghaddam¹,

Fathi²,

Jame³

et al. 2023

ACC

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Background: We assessed predictors of mortality in the intensive care unit (ICU) and investigated if Glasgow coma scale (GCS) is associated with mortality in patients undergoing endotracheal intubation (EI).Methods: From February 2020, we performed a 1-year study on 2,055 adult patients admitted to the ICU of two teaching hospitals. The outcome was mortality during ICU stay and the predictors were patients’ demographic, clinical, and laboratory features.Results: EI was associated with a decreased risk for mortality compared with similar patients (adjusted odds ratio [AOR], 0.32; P=0.030). This shows that EI had been performed correctly with proper indications. Increasing age (AOR, 1.04; P<0.001) or blood pressure (AOR, 1.01; P<0.001), respiratory problems (AOR, 3.24; P<0.001), nosocomial infection (AOR, 1.64; P=0.014), diabetes (AOR, 5.69; P<0.001), history of myocardial infarction (AOR, 2.52; P<0.001), chronic obstructive pulmonary disease (AOR, 3.93; P<0.001), immunosuppression (AOR, 3.15; P<0.001), and the use of anesthetics/sedatives/hypnotics for reasons other than EI (AOR, 4.60; P<0.001) were directly; and GCS (AOR, 0.84; P<0.001) was inversely related to mortality. In patients with trauma surgeries (AOR, 0.62; P=0.014) or other surgical categories (AOR, 0.61; P=0.024) undergoing EI, GCS had an inverse relation with mortality (accuracy=82.6%, area under the receiver operator characteristic curve=0.81).Conclusions: A variety of features affected the risk for mortality in patients admitted to the ICU. Considering GCS score for EI had the potential of affecting prognosis in subgroups of patients such as those with trauma surgeries or other surgical categories.

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Section: Discussionmentioning

confidence: 99%