Abstract
Abstract: Glasgow coma scale (GCS) is one of the most important parameters in deciding rapid sequential intubation (RSI) in emergency department (ED). The aim of this study is to determine the effectiveness of the GCS and each of its parameters in making RSI decisions in non-traumatic patients brought to the ED.
Methods: This prospective observational study was conducted in an ED of a tertiary training and research hospital, which accepts approximately 250.000 patients annually. The value of GCS and GCS parameters in deciding to intubation in patients with an RSI indication was compared with the Pearson χ2 test. Multivariate logistic regression analysis was used for assessment of combinations of GCS parameters.
Results: A total of 276 patients were included in the study. It was found that the mortality rates was statistically significantly higher in the cases with GCS 4-10 (including) in the combinations with the low motor response. Motor scoring was more statistically significant for mortality in the evaluation made by creating 120 combinations between the remaining 4-14 GCS scores after the 3 and 15 GCS scores of the cases were removed from the GCS scores.
Conclusion: It was found that the motor response showed more linear progress compared to the verbal response and eye response evaluation, and the other parameters were not linear in the evaluation between the GCS total score and GCS combinations of the cases. Motor response was determinant in the total GCS score.