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

Introduction: The purpose of the 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).
Methods: A total of 100 major trauma patients admitted to Uludað University Faculty of Medicine ED who 18 years of age or were over were included in the study. In this prospective study, RTS, ISS, TRISS, MGAP and GAP scores of the patients were calculated.
Results: A significant positive correlation was established between ISS, TRISS, MGAP, and GAP in predicting in-hospital mortality(p<0.0001). Short-term(24 hour) and long-term(4-week) mortality prediction rates and Area Under Curve(AUC) in ROC analysis were 0.727- 0.680 for RTS, 0.863-0.816 for ISS, 0.945-0,911 for TRISS, 0.970-0.938 for MGAP, and 0.910-0.904 for GAP. All calculated trauma scoring systems revealed a significant mortality prediction power(p<0.001). GAP score was found statistically and significantly selective and sensitive in predicting both in-ED and in-hospital mortality(p=0.0001).
Conclusion: In major trauma patients, GAP score is an easily calculable system both in the field and at the time of admission in the EDs by providing emergency physicians with future decision-making schemes by means of mortality prediction of the patients.

Acil Servise Baþvuran Major Travma Hastalarýnýn Mortalite Tahmininde Glasgow Koma Skalasý -Yaþ - Arteriel Kan Basýncý (GAP) skorun deðerliliði

Amaç: Bu çalýþmanýn amacý yeni bir travma skorlama sistemi olan GAP skorunun Acil Servis (AS)’e baþ vuran major travma hastalarýnda mortalite tahmin gücünü deðerlendirmektir.
Yöntemler: Uludað Üniversitesi Týp Fakültesi Hastanesi AS’ ine baþvuran ≥18 yaþ majör travmalý 100 hasta çalýþmaya alýndý. Hasta verileri prospektif olarak deðerlendirilerek hastalarýn RTS, ISS, TRISS, MGAP ve GAP skorlarý hesaplandý.
Bulgular: Hastane içi mortaliteyi öngörmede, ISS, TRISS, MGAP ve GAP arasýnda pozitif yönde anlamlý bir korelasyon saptandý(p<0.0001). Travma skorlama sistemlerinin sýrasýyla kýsa dönem(24 saat) ve uzun dönem(4 hafta) mortalite tahmin oranlarý ROC analizinde Eðri Altýndaki Alan(EAA)- Area Under Curve(AUC); RTS için 0.727- 0.680, ISS için 0.863-0.816, TRISS için 0.945-0,911 MGAP için 0.970-0.938, GAP için 0.910-0.904 olarak bulundu. Hesaplanan travma skorlarýnýn hepsinin mortalite tahmin gücü anlamlý olarak bulundu(p<0.001). GAP’ýn hem AS’ de, hem de hastane içi mortaliteyi öngörmede istatistiksel olarak anlamlý bir þekilde(p=0.0001) seçici ve duyarlý olduðu belirlendi.
Sonuç: Bu sonuçlarla GAP skorunun travma hastalarýnda, hem sahada ve hem de baþvuru anýnda AS’ de kolayca hesaplanabilecek ve hastanýn mortalitesini öngörerek AS doktoruna fikir verebilecek bir skorlama sistemi olduðunu düþünmekteyiz.