COMPARATIVE ANALYSIS OF ACCURACY AMONG GLASGOW COMA SCALE, TRAUMA SCORE, AND REVISED TRAUMA SCORE AS PREDICTORS OF MORTALITY HEAD INJURY PATIENTS
Abstract: Measurement of
severity and mortality predictions in cases of head injury is an important step
to support appropriate, effective and efficient clinical decision-making.
Glasgow Coma Score, Trauma Score, and Revised Trauma Score are physiologycal
scoring systems that can be used as predictors of mortality of head injury
patients. The objective of the study was to know which scoring systems had the
best accuracy as a predictor of mortality of head injured patients. The
observational analytic study with this retrospective cohort design approach was
carried out at dr. Iskak Tulungagung on Medical Record. Data taken from all
patient medical records from January 2016 to July 2017 amounted to 150 medical
records. Variables used were GCS, RTS, and TS scores when patients were
admitted to hospital IGD as well as patient mortality data within 7 days of
treatment. The data obtained is then processed with SPSS 20 using Mann Whitney
Test, logistic regression and ROC curve comparison. Based on the results of
multivariate logistic regression analysis, GCS accuracy results: sensitivity=
0.7586, specificity= 0.7934, PPV= 0.468, NPV= 0.932; RTS accuracy: sensitivity=
0.766, specificity= 0.8, PPV= 0.489, and NPV= 0.932; TS accuracy: sensitivity=
0.7, specificity= 0.783, PPV= 0.4468, NPV= 0.9126. The comparison graph
analysis of ROC curve showed no significant difference of AUC between GCS, RTS,
and TS because the difference was too low (<15%). There was no significant
difference of accuracy between RTS, GCS, and TS use in predicting head injury
mortality.
Keywords: Mortality, Head
Injury Patient, RTS, GCS, TS.
Penulis: Riki Ristanto, Amin
Zakaria, Heny Nurmayunita
Kode Jurnal: jpkeperawatandd170100