Prediction Value the GAP and Revised GAP score in the Hospital Outcome of Multi-trauma Patients

Abstract

Trauma is a time-sensitive condition. Especially in the first hour of trauma, it is very important to manage, evaluate, resuscitate and take care of the patient. The use of convenient and easy trauma severity scoring systems helps physicians decide how long to treat patients. The aim of this study is to evaluation of prediction value the GAP and Revised GAP score in the hospital outcome of multi-trauma patients. Materials and Methods: This study was cross-sectional study and performed in 2019 to 2020 in the pre-hospital emergency center of Tabriz and Imam Reza and Shohada Hospital of Tabriz, which are the referral centers for trauma patients. The sample size of this study was estimated to be 2000 people. The sampling method in this study was census based on inclusion and exclusion criteria. To conduct the study after explaining the study to the participants and their companions of one degree and obtaining informed consent, information about age, sex, Respiratory Rate, O2 saturation, heart rate, initial blood pressure, primary GCS, level of consciousness based on AVPU, trauma mechanism, the type of vehicle involved in the accident, the location of the injured person in the vehicle, the location of the accident, the hospital outcome including mortality in the emergency department, mortality in the collected ward and the final diagnosis of the patients were recorded. The final outcome was recorded as death or alive at the time of discharge from the hospital. Patients' outcome was also recorded using the GOS (Glasgow Outcome Scale) system. Based on the obtained data, GAP, Revised GAP, NTS scores were also collected and their results were compared with the designed model. Results: In this study, the mean (standard deviation) age of the subjects was 34.09 (±15.2) years. The highest outcome of patients based on GOS system was recovery, moderate disability and severe disability with 1309 cases (54.9%), 743 cases (31.2%) and 212 cases (8.9%), respectively. The mean (SD) of GAP score in the subjects was 21.83 (±3.1) and the severity of GAP in most subjects in this study was low with 2143 cases (89.9%). Also, The mean (SD) of Revised GAP score in the subjects was 21.47 (±3.4) and the severity of Revised GAP in most subjects in this study was low with 1994 cases (83.6%). The mean (SD) of NTS score in the subjects was 21.27 (±3.3) and the severity of NTS in most subjects in this study was low with 2138 cases (89.7%). Among the significant variables included in the regression model, all variables O2sat, primary GCS, GAP, Revised GAP and NTS with adjustment on other variables significantly the odds os mortality predicted 0.416, 0.622, 0.595, 0.601 and 0.637 times, respectively (P-value <0.001).