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ORIGINAL ARTICLE
Year : 2019  |  Volume : 14  |  Issue : 2  |  Page : 94-98

Predictive value of glasgow coma score and its components in interpreting outcome in trauma patients


1 Department of Anesthesia and Neurocritical Care, Narayana Medical College Hospital, Nellore, Andhra Pradesh, India
2 Department of Statistics, Bhabha Atomic Research Centre, Mumbai, Maharashtra, India
3 Department of Surgery, Bhabha Atomic Research Centre, Mumbai, Maharashtra, India
4 Department of Surgery, Lokmanya Tilak Municipal Medical College and General Hospital, Mumbai, Maharashtra, India
5 Department of Social Sciences, Tata Institute of Social Sciences, Mumbai, Maharashtra, India
6 Department of Neurosurgery, Narayana Medical College Hospital, Nellore, Andhra Pradesh, India

Correspondence Address:
Dr. Amit Agrawal
Department of Neurosurgery, Narayana Medical College Hospital, Chinthareddypalem, Nellore - 524 003, Andhra Pradesh
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/jdmimsu.jdmimsu_16_18

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Background: Glasgow coma score (GCS) are widely used as primary diagnostic tool in trauma cases. In literature study of GCS is seen to be addressed in specific trauma context such as traumatic brain injury, ischemic trauma, and neurotrauma. GCS score on admission is said to be associated with survival of trauma patients. Aims: This study aims to evaluate the efficacy of GCS and its components, eye, verbal, and motor response in all types of trauma in multicenter trauma database in India. Settings: Towards Improved Trauma Care Outcome (TITCO) registry conducted in four city government hospitals in India. Materials and Methods: TITCO database contains information of 16,047 patients, we included 13,836 patients with valid GCS and its components score in this study. The total GCS score is classified as mild (>12), moderate (9–12), and severe (<9). Logistic regression is applied considering GCS and components as independent with overall mortality as a dependent variable. Receivers operating characteristic (ROC) curve is drawn to evaluate the efficacy of GCS and components. Results: Compared to severe GCS score, moderate and mild GCS score is found to have better chances of survival with odds of 6.45 and 17.25, respectively. Similar results are found to be replicated in cases eye, verbal, and motor response. Motor component appeared as a better predictor than eye and verbal response. Area under the curve of ROC was 0.813, 0.775, 0.791, and 0.798 for GCS total, eye, verbal, and motor response, respectively. Conclusions: GCS and components are appeared as the best indicator of predicting overall mortality in all the trauma cases.


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