Value of the Glasgow Coma Scale, Age, and Arterial Blood Pressure (GAP) Score for Predicting the Mortality of Major Trauma Patients Presenting to the Emergency Department

Ahun, Erhan; Köksal, Özlem; Sığırlı, Deniz; Torun, Gökhan; Dönmez, Serdar Suha; Armağan, Erol

doi:10.5505/tjtes.2014.76399

Cited by 42 publications

(62 citation statements)

References 12 publications

(15 reference statements)

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“…When stratifying MGAP scores as low (23)(24)(25)(26)(27)(28)(29), intermediate (18)(19)(20)(21)(22) and high (3-17) risk for death, the in-hospital mortality rates were uniformly higher than in the original validation cohort of the MGAP score in France (Table 3). The area under the ROC curve for the MGAP score in the French validation cohort was 0.90, compared with 0.85 in the subset of patients with sufficient data to Fig.…”

Section: Resultsmentioning

confidence: 99%

“…One concern is that vital sign measurements occurred at the time of hospital triage, not at a fixed interval after the injury event, which may introduce bias as vital signs fluctuate over time and with resuscitative measures. However, vital signs collected at the time of hospital arrival are routinely used for injury scoring in low-and middle-income countries without adjusting for time since injury [19,22,[26][27][28]. In fact, because physiologic scoring systems do not rely on comprehensive anatomic evaluation, they potentially provide a more feasible means of estimating injury severity in low-and middle-income countries using readily available clinic or administrative data [29].…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Choice of injury scoring system in low- and middle-income countries: Lessons from Mumbai

Laytin

Kumar

Juillard

et al. 2015

Injury

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Choice of injury scoring system in low- and middle-income countries: Lessons from Mumbai

Laytin

Kumar

Juillard

et al. 2015

Injury

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“…Besides that, GAP scores are also more practical use in the field compared to RTS. 7,8 In this study it was found that there was a negative correlation with moderate strength and significance between GAP scores and the IL-6 cytokines (Pearson correlation -0.399 and p = 0.002). Yutaka Kondo et al stated that GAP score may reflect the severity of the trauma and predict mortality in trauma patients better than other trauma scoring system.…”

Section: Discussionmentioning

confidence: 84%

Relationship between the injury severity score and GAP score with IL-6 cytokine in fracture patients with multiple trauma

2016

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Background: ISS, GAP scores and the cytokines IL-6 reflects the severity of an injury. Recently levels of the cytokine IL-6 are the best biomarker that reflects the severity of the trauma. There has been no research on the relationship between ISS and GAP scores with IL-6 cytokine level in fracture patients with multiple traumas. This study is a cross-sectional observational study. Methods: All fracture patients treated at Sanglah Emergency Unit started in January 2016 that met the inclusion criteria became sample. At sample, we calculate ISS and GAP scores and took blood samples for examination of IL-6 cytokine level. Bivariate analysis performed by Chi-square to determine the relationship between ISS and GAP score with IL-6 cytokine level. Results: Samples were 60 patients from January to April 2016. In this study, the correlation between the ISS and IL-6 cytokines was 0.05 (p=0.705), whereas the correlation between GAP scores and IL-6 cytokines was -0.399 (p=0.002). Conclusions: In this study there was positive correlation that weak and not significant between the ISS and IL-6 cytokines and there was a negative correlation that had moderate strength and significant between GAP scores and IL-6 cytokines.

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“…This heterogeneity has been stimulating numerous scientific researches, especially with regard to the development of Trauma Scoring Systems (TSS), which involve the attribution of a certain score to trauma victims depending on specific variables. 8,9 Trauma scoring systems may guide decisions involving both prehospital care-for example, if a specialized transport is required-and inhospital caresuch as, whether or not certain surgical procedures should be performed. In addition, TSS also provide important information concerning the anatomy of the lesions, physiological changes, and prognosis.…”

Section: Introductionmentioning

confidence: 99%

“…Furthermore, TSS provide epidemiological data that may guide campaigns on trauma prevention. 9,10 Over the past years, a wide array of TSS were developed, including RTS, which considers three physiological parameters: Respiratory rate, systolic blood pressure and GCS. 11 Despite remaining widely used and discussed, the calculation of RTS involves overly complex formulas, which could delay trauma care to the patient.…”

Section: Introductionmentioning

confidence: 99%

Mortality Prediction in Trauma Patients using Three Different Physiological Trauma Scoring Systems

Razente¹,

Alvarez²,

Lacerda³

et al. 2017

Panamerican Journal of Trauma, Critical Care &Amp; Emergency Surgery

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Background: This study aims to compare mortality prediction capabilities of three different physiological trauma scoring systems (TSS): Revised Trauma Score (RTS); Glasgow Coma Scale, Age, and Systolic Blood Pressure (GAP); and Mechanism, Glasgow Coma Scale, Age, and Arterial Pressure (MGAP).Study design: A descriptive, cross-sectional study of trauma victims admitted to the emergency service between December-2013 and February-2014. Clinical and epidemiological information were gathered at admission and three TSS were calculated: RTS, GAP, and MGAP. The follow-up period to assess length of hospitalization and mortality lasted until August-2014. Two groups were created -survivals (S) and deaths (D) -and compared. P < 0.05 was considered statistically significant. Results:A total of 668 trauma victims were analyzed. The mean age was 37 ± 18 and 69.8% were males. Blunt trauma prevailed (90.6%). The mean scores of RTS, GAP, and MGAP for group S (n = 657; 98.4%) were 7.77 ± 0.33, 22.8 ± 1.7, and 27.4 ± 2.3 respectively (p < 0.001), whereas group D (n = 11, 1.6%) achieved mean scores of 4.57 ± 2.95, 13 ± 7, and 15.5 ± 7 (p < 0.001). Regarding the Receiver Operating Characteristics (ROC) analysis, the areas under the curve were 0.926 (RTS), 0.941 (GAP), and 0.981 (MGAP). The three TSS demonstrated significant mortality prediction capabilities (p < 0.001). There was no statistically significant difference between the three ROC curves (p = 0.138). The MGAP achieved the highest sensitivity (100%), while GAP and RTS sensitivities were 81.8% (59-100%), and 90.9% (73.9-100%) respectively (p < 0.001). The observed specificities were 96.2% (94.77-97.7%) for GAP, 91.6% (89.5-93.7%) for MGAP, and 87.2% (84.7-89.8%) for RTS (p < 0.001). Age (p = 0.049), Glasgow Coma Scale (GCS) (p < 0.001), and trauma mechanism (p < 0.001) were different between the two groups. Conclusion:Most patients were young males and victims of blunt trauma. The three TSS demonstrated reliability regarding mortality prediction. The MGAP achieved the highest sensitivity and GAP was the most specific score, which may indicate a potential use of both as valuable alternatives to RTS. Keywords:Cross-sectional studies, Emergency medical services, Glasgow coma scale, Hospitalization, Mortality, Receiver operating characteristics curve, Sensitivity and specificity, Trauma severity indices, Triage. Resultados: Analisaram-se 668 vítimas de trauma. Registrou-se média de idade de 37±18 anos, 69,8% sendo masculinos. Predominou o trauma contuso (90,6%). Para o grupo S (n = 657; 98,4%), as médias de RTS, GAP e MGAP foram, respectivamente, 7,77 ± 0,33, 22,8 ± 1,7 e 27,4 ± 2,3 (p < 0,001), enquanto o grupo O (n = 11, 1,6%) obteve médias de 4,57 ± 2,95, 13 ± 7 e 15,5 ± 7 (p < 0,001). A análise Receiver Operating Characteristics (ROC) revelou áreas abaixo da curva de 0,926 (RTS),

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Value of the Glasgow Coma Scale, Age, and Arterial Blood Pressure (GAP) Score for Predicting the Mortality of Major Trauma Patients Presenting to the Emergency Department

Abstract: BACKGROUND:The purpose of this study is to detect the mortality predictive power of new Glasgow coma scale, age, and arterial pressure (GAP) scoring system in major trauma patients admitted to the emergency department (ED).

Cited by 42 publications

References 12 publications

Choice of injury scoring system in low- and middle-income countries: Lessons from Mumbai

Choice of injury scoring system in low- and middle-income countries: Lessons from Mumbai

Relationship between the injury severity score and GAP score with IL-6 cytokine in fracture patients with multiple trauma

Mortality Prediction in Trauma Patients using Three Different Physiological Trauma Scoring Systems

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