Evaluation of Prognostic Scores in Patients with Head Trauma in the Emergency Department

Abstract

Background: The aim of this study was to investigate the effectiveness of Glasgow coma scale (GCS), GCS-motor component (mGCS), and FOUR (Full Outline of Un-responsiveness) Scores in predicting the prognosis of patients who presented to the emergency department with head trauma. Methods: In this prospective cross-sectional study, was obtained to collected data of patients with head trauma, who presented to the emergency department. Participants’ demographic data, medical history, GCS, FOUR scores, the duration of emergency department stays, as well as 24-hour, 7-day, and 28-day mortality rates were recorded on the case report forms. Results: Data from 302 patients were used to develop a risk score for detecting significant brain pathology via computed tomography (CT) scans. The regression model, incorporating total GCS and sex-based variables, explained 22.5% of variance and accurately classified 91.1% of cases. The model's area under the curve for detecting significant pathology via CT was 0.714. Conclusion: GCS, mGCS, and FOUR scores did not achieve the necessary the diagnostic performance benchmark to be used alone to predict or exclude clinically significant brain injury in patients with head trauma.

Keywords

• Glasgow Coma Scale
• Head Trauma
• Acute Brain Injuries
• FOUR score

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