Mortality prediction of head abbreviated injury score and Glasgow Coma Scale

Analysis of 7,764 head injuries

Demetrios Demetriades, Eric Kuncir, James Murray, George C. Velmahos, Peter M Rhee, Linda Chan

Research output: Contribution to journalArticle

112 Citations (Scopus)

Abstract

Background We assessed the prognostic value and limitations of Glasgow Coma Scale (GCS) and head Abbreviated Injury Score (AIS) and correlated head AIS with GCS. Study design We studied 7,764 patients with head injuries. Bivariate analysis was performed to examine the relationship of GCS, head AIS, age, gender, and mechanism of injury with mortality. Stepwise logistic regression analysis was used to identify the independent risk factors associated with mortality. Results The overall mortality in the group of head injury patients with no other major extracranial injuries and no hypotension on admission was 9.3%. Logistic regression analysis identified head AIS, GCS, age, and mechanism of injury as significant independent risk factors of death. The prognostic value of GCS and head AIS was significantly affected by the mechanism of injury and the age of the patient. Patients with similar GCS or head AIS but different mechanisms of injury or ages had significantly different outcomes. The adjusted odds ratio of death in penetrating trauma was 5.2 (3.9, 7.0), p < 0.0001, and in the age group ≥ 55 years the adjusted odds ratio was 3.4 (2.6, 4.6), p < 0.0001. There was no correlation between head AIS and GCS (correlation coefficient -0.31). Conclusions Mechanism of injury and age have a major effect in the predictive value of GCS and head AIS. There is no good correlation between GCS and head AIS.

Original languageEnglish (US)
Pages (from-to)216-222
Number of pages7
JournalJournal of the American College of Surgeons
Volume199
Issue number2
DOIs
StatePublished - Aug 2004
Externally publishedYes

Fingerprint

Glasgow Coma Scale
Craniocerebral Trauma
Mortality
Wounds and Injuries
Logistic Models
Odds Ratio
Regression Analysis
Hypotension
Age Groups

ASJC Scopus subject areas

  • Surgery

Cite this

Mortality prediction of head abbreviated injury score and Glasgow Coma Scale : Analysis of 7,764 head injuries. / Demetriades, Demetrios; Kuncir, Eric; Murray, James; Velmahos, George C.; Rhee, Peter M; Chan, Linda.

In: Journal of the American College of Surgeons, Vol. 199, No. 2, 08.2004, p. 216-222.

Research output: Contribution to journalArticle

Demetriades, Demetrios ; Kuncir, Eric ; Murray, James ; Velmahos, George C. ; Rhee, Peter M ; Chan, Linda. / Mortality prediction of head abbreviated injury score and Glasgow Coma Scale : Analysis of 7,764 head injuries. In: Journal of the American College of Surgeons. 2004 ; Vol. 199, No. 2. pp. 216-222.
@article{e14e457c31a04494aef6e02ec5b75fc2,
title = "Mortality prediction of head abbreviated injury score and Glasgow Coma Scale: Analysis of 7,764 head injuries",
abstract = "Background We assessed the prognostic value and limitations of Glasgow Coma Scale (GCS) and head Abbreviated Injury Score (AIS) and correlated head AIS with GCS. Study design We studied 7,764 patients with head injuries. Bivariate analysis was performed to examine the relationship of GCS, head AIS, age, gender, and mechanism of injury with mortality. Stepwise logistic regression analysis was used to identify the independent risk factors associated with mortality. Results The overall mortality in the group of head injury patients with no other major extracranial injuries and no hypotension on admission was 9.3{\%}. Logistic regression analysis identified head AIS, GCS, age, and mechanism of injury as significant independent risk factors of death. The prognostic value of GCS and head AIS was significantly affected by the mechanism of injury and the age of the patient. Patients with similar GCS or head AIS but different mechanisms of injury or ages had significantly different outcomes. The adjusted odds ratio of death in penetrating trauma was 5.2 (3.9, 7.0), p < 0.0001, and in the age group ≥ 55 years the adjusted odds ratio was 3.4 (2.6, 4.6), p < 0.0001. There was no correlation between head AIS and GCS (correlation coefficient -0.31). Conclusions Mechanism of injury and age have a major effect in the predictive value of GCS and head AIS. There is no good correlation between GCS and head AIS.",
author = "Demetrios Demetriades and Eric Kuncir and James Murray and Velmahos, {George C.} and Rhee, {Peter M} and Linda Chan",
year = "2004",
month = "8",
doi = "10.1016/j.jamcollsurg.2004.02.030",
language = "English (US)",
volume = "199",
pages = "216--222",
journal = "Journal of the American College of Surgeons",
issn = "1072-7515",
publisher = "Elsevier Inc.",
number = "2",

}

TY - JOUR

T1 - Mortality prediction of head abbreviated injury score and Glasgow Coma Scale

T2 - Analysis of 7,764 head injuries

AU - Demetriades, Demetrios

AU - Kuncir, Eric

AU - Murray, James

AU - Velmahos, George C.

AU - Rhee, Peter M

AU - Chan, Linda

PY - 2004/8

Y1 - 2004/8

N2 - Background We assessed the prognostic value and limitations of Glasgow Coma Scale (GCS) and head Abbreviated Injury Score (AIS) and correlated head AIS with GCS. Study design We studied 7,764 patients with head injuries. Bivariate analysis was performed to examine the relationship of GCS, head AIS, age, gender, and mechanism of injury with mortality. Stepwise logistic regression analysis was used to identify the independent risk factors associated with mortality. Results The overall mortality in the group of head injury patients with no other major extracranial injuries and no hypotension on admission was 9.3%. Logistic regression analysis identified head AIS, GCS, age, and mechanism of injury as significant independent risk factors of death. The prognostic value of GCS and head AIS was significantly affected by the mechanism of injury and the age of the patient. Patients with similar GCS or head AIS but different mechanisms of injury or ages had significantly different outcomes. The adjusted odds ratio of death in penetrating trauma was 5.2 (3.9, 7.0), p < 0.0001, and in the age group ≥ 55 years the adjusted odds ratio was 3.4 (2.6, 4.6), p < 0.0001. There was no correlation between head AIS and GCS (correlation coefficient -0.31). Conclusions Mechanism of injury and age have a major effect in the predictive value of GCS and head AIS. There is no good correlation between GCS and head AIS.

AB - Background We assessed the prognostic value and limitations of Glasgow Coma Scale (GCS) and head Abbreviated Injury Score (AIS) and correlated head AIS with GCS. Study design We studied 7,764 patients with head injuries. Bivariate analysis was performed to examine the relationship of GCS, head AIS, age, gender, and mechanism of injury with mortality. Stepwise logistic regression analysis was used to identify the independent risk factors associated with mortality. Results The overall mortality in the group of head injury patients with no other major extracranial injuries and no hypotension on admission was 9.3%. Logistic regression analysis identified head AIS, GCS, age, and mechanism of injury as significant independent risk factors of death. The prognostic value of GCS and head AIS was significantly affected by the mechanism of injury and the age of the patient. Patients with similar GCS or head AIS but different mechanisms of injury or ages had significantly different outcomes. The adjusted odds ratio of death in penetrating trauma was 5.2 (3.9, 7.0), p < 0.0001, and in the age group ≥ 55 years the adjusted odds ratio was 3.4 (2.6, 4.6), p < 0.0001. There was no correlation between head AIS and GCS (correlation coefficient -0.31). Conclusions Mechanism of injury and age have a major effect in the predictive value of GCS and head AIS. There is no good correlation between GCS and head AIS.

UR - http://www.scopus.com/inward/record.url?scp=3242719787&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=3242719787&partnerID=8YFLogxK

U2 - 10.1016/j.jamcollsurg.2004.02.030

DO - 10.1016/j.jamcollsurg.2004.02.030

M3 - Article

VL - 199

SP - 216

EP - 222

JO - Journal of the American College of Surgeons

JF - Journal of the American College of Surgeons

SN - 1072-7515

IS - 2

ER -