Detail Research Data


Data Resident (PPDS)
Research Title The accuracy of the Glasgow Coma Scale in Predicting Outcome in Patients with Altered of Consciousness in Emergency Department of Cipto Mangunkusumo Hospital
Kaji Etik Pass Number
Kaji Etik Pass Date 24 Maret 2014
Focus Others (-)
Principal Investigator Ismail Hari Wahyu
Pembimbing 1 Aida Rosita Tantri
Pembimbing 2 dr. Riyadh Firdaus SpAn
Departement Anesthesiology
Category Other
Research Date 24 Maret 2014
Research Object Manusia
Fund Source
Level Penelitian Resident (PPDS)
Abstract

Background Altered level of consciousness is a medical emergency that must be
manage immediatly to reduce further damage. Glasgow Coma Scale (GCS) is
used to assess the level of consciousness in citically ill patients. GCS indicates the
severity of brain damage and predictor of patient outcomes.
Objective To assess accuracy of GCS in predicting outcome for patients with
altered level of consciousness in Emergency Department of Cipto Mangunkusumo
Hospital.
Method This study is a observational prospective cohort study. Samples were 116
patients aged ≥ 18 years with a Glasgow Coma Scale below 15 at the time of
admisssion in the Emergency Department of Cipto Mangunkusumo Hospital.
Glasgow Coma Scale was assessed when patients first arrived in the Emergency
Department. To assess outcome, researchers used The Glasgow Outcome Scale.
Glasgow Outcome Scale was reviewed 2 weeks after admission for every sample.
Results The mean patient age was 51.4 ± 16.4 years, median GCS 9 (3-14). The
Glasgow Outcome Scale classified into bad outcome (death and severe disability)
66 patients (56.9%) and good outcome (moderate disability and good recovery) 50
patients (43.1%). The difference in GCS score between both outcome group were
statistically significant (p < 0,001). Each of patient's GCS-E, GCS and GCS-M-V
in bad outcome groups differ significantly with good outcome group (p < 0,001).
The results of logistic regression, GCS components that have predictive value to
the outcome are verbal and eye opening component. Calibration test showed that
total GCS score and GCS E+V score has good quality. The results of
discrimination test showed total GCS score has a AUC of 0.788 (IK95% from
0.705 to 0.870). GCS score E+V has AUC of 0.777 (IK95% from 0.690 to 0.864).
GCS’s cut off point was ≤ 9. Kappa Test between doctors and nurses to the GCS
score showed very strong results of Kappa 0.901 (p < 0,001).
Conclusion Glasgow Coma Scale can predict outcome in patients with altered
level of consciousness in the Emergency Department of Cipto Mangunkusumo
Hospital, because of its good calibration and discrimination.
Keywords Glasgow Coma Scale, altered of consciousness, Glasgow Outcome
Scale