The comparison of modified early warning score and Glasgow coma scale‑age‑systolic blood pressure scores in the assessment of nontraumatic critical patients in Emergency Department

Abstract

Introduction: The purpose of this study is to assess and compare the discriminatory ability of the Glasgow coma scale (GCS)‑age‑systolic blood pressure (GAP) score and modified early warning scoring system (mEWS) score for 4‑week mortality, for the patients being in the triage category 1 and 2 who refer to Emergency Department (ED).

Methods: Five hundred and two nontraumatic cases being in the triage category 1 and 2 who were ≥18‑year‑old and who referred to ED were assessed prospectively. Reason of referral, fashion of referral, age, gender, vital signs, GCS/alert/verbal/ painful/unresponsive scores, consultations, diagnoses, and treatments and final outcome (hospitalization, transfer, discharge, treatment rejection, and exitus) were recorded. The mEWS and GAP scores and the mortality ratios of the cases were calculated by observing both in ED and 4‑week survivals of the patients.

Results: When the mEWS and GAP scores were compared in the prediction of 4‑week mortality, no statistically significant difference was found between them (P > 0.05). The power of mortality estimation was found significant for both scoring systems (for both; P < 0.001).

Conclusion: GAP score with a simple use being a score developed for the estimation of mortality of trauma patients seems to be usable also for the nontraumatic patients with triage category 1–2 in the ED.

Keywords: Glasgow coma scale‑age‑systolic blood pressure score, modified early warning scoring system, mortality, nontraumatic critical patient