Predictive Value of Initial Glasgow Coma Scale Score in Pediatric Trauma Patients
Predictive Value of Initial Glasgow Coma Scale Score in Pediatric Trauma Patients
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DOI：
10.1097/pec.0b013e31827b52bf
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发表时间：
2013-01-01
影响因子：
1.4
通讯作者：
Cross, Keith P.
中科院分区：
文献类型：
--
作者：
Cicero, Mark X.;Cross, Keith P.
目的：本研究的目的是确定格拉斯哥昏迷量表（GCS）和格拉斯哥运动成分（GMC）对总死亡率、到达时死亡和重大损伤的预测价值，以及GCS与急诊科（ED）和医院住院时间（LOS）之间的关系。方法：提取美国外科医师学会国家创伤数据库2007 - 2009年的记录。患者0至18岁从创伤现场运送完整的初始现场数据包括在内。统计分析，包括构建接受者-操作者曲线，确定GCS、GMC与感兴趣的临床结果之间的相关性。结果：有完整资料可供分析的记录104035份，其中死亡3946例。患者平均年龄为12.6岁（SD, 5.5）岁。格拉斯哥昏迷量表预测总死亡率，接受者-操作者曲线下面积（AUC）为0.946(95%可信区间[CI]， 0.941-0.951)；到达时死亡，AUC为0.958 (95% CI, 0.953-0.963)；重大损伤风险，AUC为0.720（0.715-0.724）。较低的GCS评分与较短的ED LOS和较长的住院时间相关(P
Objective: The objective of this study was to determine the predictive value of the Glasgow Coma Scale (GCS) and the Glasgow Motor Component (GMC) for overall mortality, death on arrival, and major injury and the relationship between GCS and length of stay (LOS) in the emergency department (ED) and hospital.Methods: Records from the American College of Surgeons National Trauma Data Base from 2007 to 2009 were extracted. Patients 0 to 18 years old transported from a trauma scene with complete initial scene data were included. Statistical analysis, including construction of receiver-operator curves, determined the correlation between GCS, GMC, and the clinical outcomes of interest.Results: There were 104,035 records with complete data for analysis, including 3946 deaths. Mean patient age was 12.6 (SD, 5.5) years. Glasgow Coma Scale was predictive of overall mortality, with area under the receiver-operator curve (AUC) of 0.946 (95% confidence interval [CI], 0.941-0.951); death on arrival, with AUC of 0.958 (95% CI, 0.953-0.963); and risk of major injury, with AUC of 0.720 (0.715-0.724). Lower GCS scores were associated with shorter ED LOS and longer hospital stays (P