Comparing logistic models based on modified GCS motor component with other prognostic tools in prediction of mortality: Results of study in 7226 trauma patients

Eftekhar, Behzad; Zarei, Mohammad Reza; Ghodsi, Mohammad; Moezardalan, Koorosh; Zargar, Moosa; Ketabchi, Ebrahim

doi:10.1016/j.injury.2004.12.067

Cited by 21 publications

(23 citation statements)

References 18 publications

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“…Regression analysis also reflected a 4.9 times risk of death for the head injured comparable to the existing literature in Iran21, 22 and throughout the world 23 . It is worth to note that sustaining a thoracic injury increased the odds of death far more than head injuries did.…”

Section: Discussionsupporting

confidence: 69%

Analysis of Shahid Rajaee hospital administrative data on injuries resulting from car accidents in Shiraz, Iran: 2011–2014 data

Yadollahi

Ghiassee

Anvar

et al. 2017

Chinese Journal of Traumatology

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PurposeThe administrative data from trauma centers could serve as potential sources of invaluable information while studying epidemiologic features of car accidents. In this cross-sectional analysis of Shahid Rajaee hospital administrative data, we aimed to evaluate patients injured in car accidents in terms of age, gender, injury severity, injured body regions and hospitalization outcome in the recent four years (2011–2014).MethodsThe hospital registry was accessed at Shiraz Trauma Research Center (Shiraz, Iran) and the admission's unit data were merged with the information gathered upon discharge. A total number of 27,222 car accident patients aged over 15 years with International Classification of Diseases 10th revision (ICD-10) external causes of injury codes (V40.9-V49.9) were analyzed. Injury severity score and injured body regions were determined based on converting ICD-10 injury codes to Abbreviated Injury Scale (AIS-98) severity codes using a domestically developed electronic algorithm. A binary logistic regression model was applied to the data to examine the contribution of all independent variables to in-hospital mortality.ResultsMen accounted for 68.9% of the injuries and the male to female ratio was 2.2:1. The age of the studied population was (34 ± 15) years, with more than 77.2% of the population located in the 15–45 years old age group. Head and neck was the most commonly injured body region (39.0%) followed by extremities (27.2%). Injury severity score (ISS) was calculated for 13,152 (48.3%) patients, of whom, 80.9% had severity scores less than 9. There were 332 patients (1.2%) admitted to the intensive care units and 422 in-hospital fatalities (1.5%) were recorded during the study period. Age above 65 years [OR = 7.4, 95% CI (5.0–10.9)], ISS above 16 [OR = 9.1, 95% CI (5.5–14.9)], sustaining a thoracic injury [OR = 7.4, 95% CI (4.6–11.9)] and head injury [OR = 4.9, 95% CI (3.1–7.6)] were the most important independent predictors of death following car accidents.ConclusionHospital administrative databases of this hospital could be used as reliable sources of information in providing epidemiologic reports of car accidents in terms of severity and outcomes. Improving the quality of recordings at hospital databases is an important initial step towards more comprehensive injury surveillance in Fars, Iran.

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Section: Discussionsupporting

confidence: 69%

Analysis of Shahid Rajaee hospital administrative data on injuries resulting from car accidents in Shiraz, Iran: 2011–2014 data

Yadollahi

Ghiassee

Anvar

et al. 2017

Chinese Journal of Traumatology

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“…The consciousness deterioration or improvement score is clearly related to the outcome. 3,4,12,15,22) The mortality risk and the eventual outcome, in-hospital mortality rate, and 3-month and 6-month mortality rates should be certainly assessed. The GCS total score was substituted in the balance of previous evidence-based discussions.…”

Section: Discussionmentioning

confidence: 99%

Endorsement of the FOUR Score for Consciousness Assessment in Neurosurgical Patients

Akavipat

2009

Neurol. Med. Chir.(Tokyo)

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The Full Outline of UnResponsiveness (FOUR) score was previously developed for neurological assessment, but has not been validated in neurosurgical patients, so was compared to the Glasgow Coma Scale (GCS) in practice. Four groups of raters, expert clinicians, novice clinicians, experienced nurses, and inexperienced nurses, assessed 64 patients in awake, drowsy, stuporous, and comatose conditions to investigate rater reliability. Then, 36 patients were evaluated by 1 expert clinician and 1 from the other groups randomly to test the difference. Spearman's correlation was used to find the correlation between both scores from 68 patients. The estimation of FOUR score cut points was validated by weighted kappa compared with the GCS to establish the risk prognosis. Score feasibility was analyzed by nonparametric test. Intraclass correlation in each group was over 0.9, with no difference between expert and inexperienced raters (p À 0.05). The correlation was 0.78. Low, intermediate, and high risk prognosis were associated with 0-7, 8-14, and 15-16 FOUR scores with kappa of 0.92. The feasibility of the FOUR score was lower than that of the GCS (p º 0.01). The FOUR score is reliable and valid for consciousness evaluation with some consequences for practicability. Extensive implementation would increase familiarity.

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“…The reliability and validity of FOUR were acceptablein other countries. [8910111213141516171819] The researcher takes the validation procure by translating the originalLatin version of FOUR[11] to Persian; then the Persian version is translated to English and the twoversions were compared. The validity of content was surveyed by two anesthesia and nursing faculty members of Medical Science University of Mazandaran.…”

Section: Methodsmentioning

confidence: 99%

“…[13] The relationship between outcomes in patients with TBI and FOUR scores has been proved although rare studies have been conducted to predict the power of FOUR among such patients. [1415] As per researchers’ knowledge, no study has been conducted in Iran up till now as this case; even in other countries also, studies included long-term follow up which can get affectedthrough several factors like physical rehabilitation, pharmacology, and treatment interventions. [16] Therefore, researchers compared the predictive power of FOUR with GCS regarding low limitations of this tool to introduce its application during the first 24 hours of acceptance of patients with TBI.…”

Section: Introductionmentioning

confidence: 99%

A comparison of the diagnostic power of the Full Outline of Unresponsiveness scale and the Glasgow coma scale in the discharge outcome prediction of patients with traumatic brain injury admitted to the intensive care unit

et al. 2014

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Background and Aim:This study aimed to determine whether the Full Outline of Unresponsiveness (FOUR) score is an accurate predictorof discharge outcome in traumatic brain injury (TBI) patients and to compare its performanceto Glasgow coma scale (GCS).Materials and Methods:Thisis diagnostic study conducted prospectively on 53 TBI patients admitted to ICU of education hospitals of Medical Science University of Mazandaran during February 2013 to June 2013. Data collection was done with a checklist including biographic, clinical information and outcome. The FOUR score and GCS were determined by the researcher in the first 24 hours. Outcomes considered as in-hospital mortality and poor neurologic outcome (Glasgow Outcome Scale (GOS) 1-3) in discharge time from the hospital.Results:In terms of predictive power for in-hospital mortality, the area under the receiver operating characteristic (ROC) curve was 0/92 (95% CI. 0/81-0/97) for FOUR score and 0/96 (95% CI. 0/87-0/99) for GCS. In terms of predictive power of poor neurologic outcome, the area under the ROC curve was 0/95 (95% CI. 0/86-0/99) for FOUR score and 0/90 (95% CI.0/79-0/96) for GCS as evidenced by GOS 1-3. The cut-off of 6 showed sensitivity and specificity of total four score predicting poor outcome at 0/86 and 0/87 while the cut-off of 4 showed the value of in hospital mortality at 0/90 and 0/90. The total GCS score showed sensitivity and specificity 0/100 and 0/61 at cut-off 7 in predicting poor outcome while in predicting mortality at cut-off of 4 this range was 0/100 and 0/92.Conclusion:The FOUR score is an accurate predictor of discharge outcome in TBI patients. Thus, researchers recommend for therapeutic Schematizationto use in neurosurgical patients at admission day.

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Comparing logistic models based on modified GCS motor component with other prognostic tools in prediction of mortality: Results of study in 7226 trauma patients

Cited by 21 publications

References 18 publications

Analysis of Shahid Rajaee hospital administrative data on injuries resulting from car accidents in Shiraz, Iran: 2011–2014 data

Analysis of Shahid Rajaee hospital administrative data on injuries resulting from car accidents in Shiraz, Iran: 2011–2014 data

Endorsement of the FOUR Score for Consciousness Assessment in Neurosurgical Patients

A comparison of the diagnostic power of the Full Outline of Unresponsiveness scale and the Glasgow coma scale in the discharge outcome prediction of patients with traumatic brain injury admitted to the intensive care unit

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