Perbedaan Glasgow Coma Scale dan Rapid Emergency Medicine Score dalam Memprediksi Outcome Pasien Trauma Kepala di Instalasi Gawat Darurat

Abstract

Initial assessment of patients with head trauma is an influence on the management of patients with head trauma. GCS was developed to describe the level of consciousness in patients with head trauma. Whereas REMS is a scoring system that has been used widely in various countries to predict the mortality of patients coming to the emergency room. The purpose of this study was to determine the differences in the effectiveness of REMS and GCS scoring on the outcome of head trauma patients in the Emergency Departement. This study uses an analytic observational design with a retrospective cohort approach. The sample consisted of 181 patients where the sampling was carried out using a purposive sampling technique in which the researchers selected samples according to the inclusion and exclusion criteria of the existing population. Bivariate analysis conducted in this study used the Somers'd test and the Spearman test. The Area Under Receiver Operating Characteristics (AUROC) is used to assess the ability of REMS and GCS scoring to distinguish good outcomes and bad outcomes. The results of this study indicate that REMS and GCS scoring has a p-value<0,05 which means there is a significant relationship with the outcome of head trauma patients. From the results of the AUROC analysis, the AUC value was 0.753 for REMS, and the AUC was 0.769 for GCS. The ability of REMS and GCS to predict the outcome of head trauma patients shows good performance. So that both can be considered used as an early detection system or Early Warning Score System (EWSS) in head trauma patients in the Emergency Departement.

Perbedaan Nilai Gap Score Terhadap Mortalitas Pasien Cedera Kepala

“…Manguharjo Madiun yang menunjukkan bahwa pasien cedera kepala banyak terjadi pada kelompok usia 16-25 tahun. 15,18 Penelitian di RSUD dr. M. Haulussy Ambon juga menunjukkan usia 15-24 tahun merupakan kelompok usia yang paling banyak mengalami cedera kepala yaitu 37 pasien (33,33%). 12 Kasus cedera kepala banyak terjadi pada usia produktif.…”

“…19 Pada rentang usia tersebut seseorang memiliki kemampuan maksimal untuk beraktivitas terutama dalam penggunaan alat transportasi darat yang mengakibatkan tingginya tingkat mobilitas dalam pekerjaan atau aktivitas lain yang sangat rentan terhadap terjadinya cedera kepala serta perkembangan psikologis yang belum stabil. [18][19][20] Tekanan darah sistolik pasien cedera kepala sebagian besar adalah 90-139 mmHg sebanyak 48 pasien (69,9%). Peningkatan tekanan darah setelah cedera kepala untuk mempertahankan tekanan darah sistolik, kemungkinan terkait dengan peningkatan katekolamin.…”

“…18 GAP score lebih mudah dinilai, baik pada tahap pre-hospital maupun pada saat masuk ke dalam IGD 27. Penjumlahan tiga komponen penilaian GAP score antara lain GCS, usia, dan…”