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Martín Quirós A, Borobia Pérez A, Pertejo Fernández A, Pérez Perilla P, Rivera Núñez A, Martínez Virto AM, Quintana Díaz M
and the score on the GAP scale (Glasgow Coma Scale, age, and systolic blood pressure).
Methods.
Retrospective observational study of all patients with potentially severe injuries treated in an emergency department (ED) over a period of 15 months. We recorded epidemiologic variables, cause of injury, type of transport, need for prehospital orotracheal intubation, substance abuse, Charlson Comorbidity Index (CCI), variables for the GAP
prognostic score, destination on discharge from the ED and at the end of the episode, and mortality.
Results.
Data for 864 patients entered the final analysis. Mortality was higher in older patients (mean [SD] age, 57.9 [26.6] vs 41.1 [17.4], P<.05) and those with a higher mean CCI (3.3 [2.9] vs 0.9 [1.7]). Accident type was a precipitating factor associated with mortality (P<.001), but substance abuse was unrelated. Patients who died had lower mean
Glasgow scores (9.1 [5.3] vs 14.8 [1.2], P<.001) and lower mean systolic and diastolic pressures (respectively, 113.8 [19.8] vs 131.3 [20.7] mm Hg, P=.012, and 60.1 [16.8] vs 77.7 [11.7] mm Hg, P=.002). Patients who died also had lower mean GAP scores than survivors (15.1 [4.8] vs 22.6 [1.7], P<.001). Risk factors that remained significant in the
multivariate analysis were CCI (odds ratio [OR], 0.704; 95% CI, 0.52–0.96) and GAP score (OR, 1.8; 95% CI, 1.45–2.20).
Conclusions.
Mortality in our patient series was lower than rates in previously published reports. The GAP score was a useful tool for predicting mortality in the series we studied.
