Validation of the Gap Score (Glasgow Coma Scale, Age, and Systolic Blood Pressure) as A Predictor of Clinical Deterioration in Head Injury Patients in the Emergency Departmen
DOI:
https://doi.org/10.37287/ijghr.v8i5.2820Keywords:
age, clinical deterioration, GAP score, glasgow coma scale, head injury, systolic blood pressureAbstract
Head injuries are a leading cause of death and disability globally and in Indonesia; therefore, early assessment of injury severity is crucial to prevent the deterioration of a patient's condition. One method that can be employed is the GAP Score a prognostic scoring system that integrates three simple parameters: the Glasgow Coma Scale (GCS), patient age, and systolic blood pressure designed to predict clinical outcomes quickly and accurately. This study aimed to determine the association between the GAP Score and the deterioration of the condition of patients with head injuries at Siti Rahmah Islamic Hospital, Padang. Method: This was an observational, analytical study with a retrospective cohort design. It utilized medical record data from all patients with head injuries treated throughout 2024, resulting in a sample size of 34 individuals selected via total sampling. Data were collected from medical records and analyzed using the Fisher’s Exact Test. The findings indicate that the majority of patients presented with a mild GCS score (91.2%), were under 60 years of age (91.2%), and had a stable systolic blood pressure between 60–120 mmHg (52.9%). Based on the GAP Score, 91.2% of patients were classified as low-risk, while 8.8% were classified as moderate-risk; clinical deterioration was observed in only 8.8% of the respondents. Statistical analysis revealed a highly significant association between the GAP Score and clinical deterioration (p = 0.000), with patients in the moderate-risk category facing a substantially higher risk. The individual parameters age, GCS, and systolic blood pressure also showed significant associations (p < 0.05). The GAP Score is an effective instrument for predicting the deterioration of a patient's condition. The GAP Score is an effective instrument for predicting clinical deterioration in head injury patients.
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