The Efficacy of Glasgow Coma Scale (GCS) Score and Acute Physiology and Chronic Health Evaluation (APACHE) II for Predicting Hospital Mortality of ICU Patients with Acute Traumatic Brain Injury

Nik, Amir; Andalibi, Mohammad Sobhan Sheikh; Ehsaei, M R; Zarifian, Ahmadreza; Karimiani, Ehsan Ghayour; Bahadoorkhan, Gholamreza

doi:10.29252/beat-060208

Cited by 38 publications

(23 citation statements)

References 20 publications

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“…The ISS, AIS, ward, and intensive care unit (ICU) stay were not normally distributed and were, therefore, displayed by median (IQR). The median (IQR) of ISS and AIS was significantly higher in the mortality group than in the survival group (25 11,17-28 and 16 [16][17][18][19][20][21][22][23][24][25] vs 18 [16][17][18][19][20][21][22][23][24][25] and 16 [9][10][11][12][13][14][15][16] , respectively). Traffic accident (45.3%) was the most common injury mechanism, with motorcycle accidents accounting for 34.7% despite wearing helmets according to the Taiwan traffic regulations.…”

Section: Resultsmentioning

confidence: 99%

“…The Glasgow Coma Scale (GCS) 15 , which is used to assess consciousness level, has also shown to possess strong correlation with mortality in patients with traumatic brain injury 16,17 . Considering these characteristics, a Japanese research group has proposed a new scoring tool, rSIG, which was derived from a multicenter retrospective study and calculated by multiplying rSI by GCS score 18 .…”

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confidence: 99%

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Reverse shock index multiplied by Glasgow Coma Scale (rSIG) predicts mortality in severe trauma patients with head injury

Wan-Ting¹,

Chin-Hsien

Cheng-Yu³

et al. 2020

Sci Rep

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The reverse shock index (rSI), a ratio of systolic blood pressure (SBP) to heart rate (HR), is used to identify prognosis in trauma patients. Multiplying rSI by Glasgow Coma Scale (rSIG) can possibly predict better in-hospital mortality in patients with trauma. However, rSIG has never been used to evaluate the mortality risk in adult severe trauma patients (injury Severity Score [iSS] ≥ 16) with head injury (head Abbreviated injury Scale [AiS] ≥ 2) in the emergency department (ED). This retrospective case control study recruited adult severe trauma patients (iSS ≥ 16) with head injury (head AIS ≥ 2) who presented to the ED of two major trauma centers between January 01, 2014 and May 31, 2017. Demographic data, vital signs, ISS scores, injury mechanisms, laboratory data, managements, and outcomes were included for the analysis. Logistic regression and receiver operating characteristic analysis were used to evaluate the accuracy of rSIG score in predicting in-hospital mortality. In total, 438 patients (mean age: 56.48 years; 68.5% were males) were included in this study. In-hospital mortality occurred in 24.7% patients. The median (interquartile range) ISS score was 20 (17-26). Patients with rSIG ≤ 14 had sevenfold increased risks of mortality than those without rSIG ≤ 14 (odds ratio: 7.64; 95% confidence interval: 4.69-12.42). Hosmer-Lemeshow goodness-of-fit test and area under the curve values for rSIG score were 0.29 and 0.76, respectively. The sensitivity, specificity, positive predictive value, and negative predictive values of rSIG ≤ 14 were 0.71, 0.75, 0.49, and 0.89, respectively. The rSIG score is a prompt and simple tool to predict in-hospital mortality among adult severe trauma patients with head injury.

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Section: Resultsmentioning

confidence: 99%

mentioning

confidence: 99%

Reverse shock index multiplied by Glasgow Coma Scale (rSIG) predicts mortality in severe trauma patients with head injury

Wan-Ting¹,

Chin-Hsien

Cheng-Yu³

et al. 2020

Sci Rep

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“…In addition to hemorrhagic shock [ 18 , 19 ], traumatic brain injury [ 20 , 21 ] is another leading cause of mortality in trauma patients. The GCS score [ 22 ] is used to assess the level of consciousness at almost every ED worldwide and has been shown to be strongly associated with the probability of mortality in patients with traumatic brain injury [ 23 , 24 ]. Recently, a retrospective study from multicenters using registered data of 168,517 patients from the Japan Trauma Data Bank proposed that a new score, the rSI multiplied by GCS score (rSIG, i.e., rSIG = SBP/HR × GCS score), can be used to identify those trauma patients with a high risk for mortality and requirement of a blood transfusion within 24 h [ 25 ].…”

Section: Introductionmentioning

confidence: 99%

The Reverse Shock Index Multiplied by Glasgow Coma Scale Score (rSIG) and Prediction of Mortality Outcome in Adult Trauma Patients: A Cross-Sectional Analysis Based on Registered Trauma Data

Rau

Kuo

et al. 2018

IJERPH

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The reverse shock index (rSI) multiplied by Glasgow Coma Scale (GCS) score (rSIG), calculated by multiplying the GCS score with systolic blood pressure (SBP)/hear rate (HR), was proposed to be a reliable triage tool for identifying risk of in-hospital mortality in trauma patients. This study was designed to externally validate the accuracy of the rSIG in the prediction of mortality in our cohort of trauma patients, in comparison with those that were predicted by the Revised Trauma Score (RTS), shock index (SI), and Trauma and Injury Severity Score (TRISS). Adult trauma patients aged ≥20 years who were admitted to the hospital from 1 January 2009 to 31 December 2017, were included in this study. The rSIG, RTS, and SI were calculated according to the initial vital signs and GCS scores of patients upon arrival at the emergency department (ED). The end-point of primary outcome is in-hospital mortality. Discriminative power of each score to predict mortality was measured using area under the curve (AUC) by plotting the receiver operating characteristic (ROC) curve for 18,750 adult trauma patients, comprising 2438 patients with isolated head injury (only head Abbreviated Injury Scale (AIS) ≥ 2) and 16,312 without head injury (head AIS ≤ 1). The predictive accuracy of rSIG was significantly lower than that of RTS in all trauma patients (AUC 0.83 vs. AUC 0.85, p = 0.02) and in patients with isolated head injury (AUC 0.82 vs. AUC 0.85, p = 0.02). For patients without head injury, no difference was observed in the predictive accuracy between rSIG and RTS (AUC 0.83 vs. AUC 0.83, p = 0.97). Based on the cutoff value of 14.0, the rSIG can predict the probability of dying in trauma patients without head injury with a sensitivity of 61.5% and specificity of 94.5%. The predictive accuracy of both rSIG and RTS is significantly poorer than that of TRISS, in all trauma patients (AUC 0.93) or in patients with (AUC 0.89) and without head injury (AUC 0.92). In addition, SI had the significantly worse predictive accuracy than all of the other three models in all trauma patients (AUC 0.57), and the patients with (AUC 0.53) or without (AUC 0.63) head injury. This study revealed that rSIG had a significantly higher predictive accuracy of mortality than SI in all of the studied population but a lower predictive accuracy of mortality than RTS in all adult trauma patients and in adult patients with isolated head injury. In addition, in the adult patients without head injury, rSIG had a similar performance as RTS to the predictive risk of mortality of the patients.

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“… 15 BHV was measured using the ABC/2 volume estimation as described by previous studies. 16 , 17 Additionally, Glasgow coma scale (GCS) score was used to evaluate level of consciousness, 18 and disease outcome was determined using Glasgow outcome scale (GOS) score. 19 Patients experiencing severe infection, abnormal blood electrolyte levels, patients with ICH related to trauma, neoplasms, coagulation disorders or thrombolytic therapy, aneurysms, or other vascular malformations were excluded.…”

Section: Methodsmentioning

confidence: 99%

Association of angiotensin-converting enzyme G2350A gene polymorphisms with hypertension among patients with intracerebral haemorrhage

Imran

Syahrul

Sofia

et al. 2019

Journal of Taibah University Medical Sciences

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Objectives To evaluate the correlation of angiotensin-converting enzyme (ACE) G2350A gene polymorphisms with hypertension, brain hematoma volume (BHV), level of consciousness, and disease outcome among intracerebral haemorrhage (ICH) patients. Methods A cross-sectional study was conducted in Zainoel Abidin General Hospital from May 2016 to June 2017. Polymerase chain reaction was used to genotype ACE G2350A gene polymorphisms. BHV was assessed using the ABC/2 volume estimation formula. Level of consciousness was assessed by Glasgow coma scale (GCS). Disease outcome was assessed using Glasgow outcome scale (GOS). Association tests for ACE G2350A genotype in the context of hypertension status, BHV, GCS score, and GOS score in subjects with ICH was analysed by multiple logistic regression. Results A total of 75 ICH patients were included in the study. Of those, 59 patients exhibited hypertension, 24 patients had BHV ≥60 cm 3 , 16 patients possessed GCS scores ≤8, and 72 patients had GOS scores of 1–3. Our analysis determined that the A allele of the ACE G2350A gene polymorphism was significantly associated with a 3.6-fold increase in hypertension; however, this polymorphism was not associated with BHV, level of consciousness, and disease outcome among ICH patients. Conclusion The A allele of the ACE G2350A gene polymorphisms is associated with hypertension among ICH patients.

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The Efficacy of Glasgow Coma Scale (GCS) Score and Acute Physiology and Chronic Health Evaluation (APACHE) II for Predicting Hospital Mortality of ICU Patients with Acute Traumatic Brain Injury

Cited by 38 publications

References 20 publications

Reverse shock index multiplied by Glasgow Coma Scale (rSIG) predicts mortality in severe trauma patients with head injury

Reverse shock index multiplied by Glasgow Coma Scale (rSIG) predicts mortality in severe trauma patients with head injury

The Reverse Shock Index Multiplied by Glasgow Coma Scale Score (rSIG) and Prediction of Mortality Outcome in Adult Trauma Patients: A Cross-Sectional Analysis Based on Registered Trauma Data

Association of angiotensin-converting enzyme G2350A gene polymorphisms with hypertension among patients with intracerebral haemorrhage

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