Comparative Analysis of Accuracy Among Glasgow Coma Scale, Trauma Score, and Revised Trauma Score as Predictors of Mortality Head Injury Patients

Abstract

Measurement of severity and mortality predictions in cases of head injury is an important step to support appropriate, effective and efficient clinical decision-making. Glasgow Coma Score, Trauma Score, and Revised Trauma Score are physiologycal scoring systems that can be used as predictors of mortality of head injury patients. The objective of the study was to know which scoring systems had the best accuracy as a predictor of mortality of head injured patients. The observational analytic study with this retrospective cohort design approach was carried out at dr. Iskak Tulungagung on Medical Record. Data taken from all patient medical records from January 2016 to July 2017 amounted to 150 medical records. Variables used were GCS, RTS, and TS scores when patients were admitted to hospital IGD as well as patient mortality data within 7 days of treatment. The data obtained is then processed with SPSS 20 using Mann Whitney Test, logistic regression and ROC curve comparison. Based on the results of multivariate logistic regression analysis, GCS accuracy results: sensitivity= 0.7586, specificity= 0.7934, PPV= 0.468, NPV= 0.932; RTS accuracy: sensitivity= 0.766, specificity= 0.8, PPV= 0.489, and NPV= 0.932; TS accuracy: sensitivity= 0.7, specificity= 0.783, PPV= 0.4468, NPV= 0.9126. The comparison graph analysis of ROC curve showed no significant difference of AUC between GCS, RTS, and TS because the difference was too low (<15%). There was no significant difference of accuracy between RTS, GCS, and TS use in predicting head injury mortality

Sistem Revised Trauma Score (Rts) Sebagai Prediktor Mortalitas Pasien Cedera Otak Traumatik Di Rsup Dr. Sardjito

“…RTS merupakan penilaian baku dalam protokol ATLS pada pasien trauma. RTS sebagai parameter prediksi mortalitas pasien cedera otak traumatik, sudah diakui penggunaannya untuk prediktor mortalitas di Washington (USA), Manchester (Inggris), Helskinki (Finlandia), dan sudah diteliti beberapa centre rumah sakit di Indonesia [8][9][10][11]. Pada penelitian Aprilia di RSUD Ulin Banjarmasin menggunakan RTS sebagai parameter penilaian status fisiologis pasien cedera kepala.Penilaian RTS berperan dalam meningkatkan pelayanan pasien 12.…”