Volume 25, Issue 115, September 2021

Prognostic value of Prehospital Index (PHI) versus GAP scale measured in hospital emergency room

Hadi Jalilvand¹, Homayoun Sadeghi-Bazargani^2♦, Ehsan Sarbazi³, Mohammad Meshkini⁴, Mohammad Asghari Jafarabadi⁵, Hassan Nouri Sari⁶, Pir-Hossein Kolivand⁷, Kavous Shahsavarinia⁸, Mina Golestani⁹, Faramarz Pourasghar¹⁰

¹MSc. of Epidemiology, Department of Epidemiology, Faculty of Health, Tabriz University of Medical Sciences, Tabriz, Iran
²Road Traffic Injury Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
³Road Traffic Injury Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
⁴Medical Emergency, Faculty of Medicine, Iran University of Medical Sciences, Tehran, Iran
⁵Department of Statistics and Epidemiology, School of Medicine, Zanjan University of Medical Sciences, Zanjan, Iran
⁶Emergency Medicine Management Research Center, Rasoul-e-Akram Hospital, Iran University of Medical Sciences, Tehran, Iran
⁷Tehran Emergency Medical Service Center, Tehran, Iran
⁸Emergency Medicine Research Team, Tabriz University of Medical Sciences, Tabriz, Iran
⁹Road Traffic Injury Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
¹⁰Department of Health Policy and Management, School of Management and Medical informatics, Tabriz University of Medical Sciences, Tabriz, Iran

^♦Corresponding author
Road Traffic Injury Research Center, Tabriz University of Medical Sciences, Tabriz, Iran

ABSTRACT

Introduction: Trauma is one of the major health problems worldwide. There are several indicators for predicting trauma mortality in the world, some of them are physiological, some anatomical, and some others are both psychological and anatomical. Our aim in this study was to compare the predictive power of GAP versus PHI in predicting mortality from trauma. Methods: This prospective study was performed using data from Imam Reza Hospital in Tabriz, HaftTir and Sina Hospital, in Tehran, during 2020 and 2021. Descriptive results were reported with mean, standard deviation, absolute frequency and absolute frequency percentage. Simple logistic regression, multiple logistic regression and receiver operating characteristic (ROC) were used to evaluate the predictive power of the studied indices. All analyses were performed at a significance level of 0.05. Results: A total of 540 trauma patients participated in this study. The mean and standard deviation of the age of the patients participating in this study was 34.71± 17.65. The majority of the patients (81.67%) were male. Finally, until the 30th day of follow-up, 62 patients (11.48 %) died. Glasgow coma scale (GCS), pulse rate, age, respiratory status and level of consciousness significantly predict trauma mortality (P-value < 0.00). The area under roc curve (AUC) value was 0.926 for PHI and 0.920 for GAP. Conclusion: GAP is a more appropriate index than PHI to predict trauma deaths and triage of trauma patients in the emergency room. We recommend that the use of GAP be prioritized over PHI for triaging patients in the emergency room.

Keywords: prediction, GAP, PHI, scale, trauma

Medical Science, 2021, 25(115), 2126-2137

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