A new method to predict the in-hospital outcome of multi-trauma patients: R-GAP

Objective: Awareness of the severity of trauma and the outcome of patients can help physicians decide how long to treat patients. The objective of this study is to design a new score (R-GAP: Revised-GCS, Age, Pressure) for multi-trauma patients and determine its predictive value concerning in-hospital outcome of these patients.Methods: This cross-sectional study was performed in the emergency ward of Imam Reza (AS) and Shohada hospitals (referral centers for trauma patients) affiliated to Tabriz University of Medical Sciences from ۲۰۱۹ to ۲۰۲۰. The sample size of this study was estimated to be ۲۰۰۰ people. Required information was collected and the final diagnosis of the patients was recorded. The hospital outcome was recorded at the time of discharge. Patients’ outcome was also recorded using the Glasgow Outcome Scale (GOS) system. Based on the obtained data, GAP, R-GAP, new trauma score (NTS) scores were also collected and their results were compared with the designed model. Receiver operating characteristic (ROC) curve and logistic regression were used to analyze the predictive value of the scores.Results: The mean age of the subjects was ۳۴.۰۹ (± ۱۵.۲۳) years. The highest outcome of patients based on the GOS system was recovery, moderate disability, and severe disability with ۱۳۰۹ cases (۵۴.۹%), ۷۴۳ cases (۳۱.۲%), and ۲۱۲ cases (۸.۹%), respectively. The mean of GAP, R-GAP, and NTS scores were ۲۱.۸۳ (± ۳.۱), ۲۱.۴۷ (± ۳.۴), and ۲۱.۲۷ (± ۳.۳), respectively. The intensity of GAP, R-GAP, and NTS in most subjects was low with ۲۱۴۳ cases (۸۹.۹%), ۱۹۹۴ cases (۸۳.۶%), and ۲۱۳۸ cases (۸۹.۷%). Among the significant variables included in the regression model, O۲sat, primary GCS, GAP, R-GAP, and NTS with modulation on other variables, significantly equalized the mortality chance by ۰.۴۱۶, ۰.۶۲۲, ۰.۵۹۵, ۰.۶۰۱, ۰.۶۳۷, respectively (P value < ۰.۰۰۱).Conclusion: According to the study results, it seems that GAP, R-GAP, and NTS respectively, have the highest strength of predictive value in the survival of patients with multiple traumas. It is suggested that a comprehensive study be conducted to better estimate this issue.

Keywords:

Multiple Traumas , outcome , mortality