title: Comparison of the acute physiology and chronic health evaluation score (APACHE) II with GCS in predicting hospital mortality of neurosurgical intensive care unit patients.
abstract: BACKGROUND
  The Glasgow Coma Scale (GCS) is popular, simple, and reliable, and provides information about the level of consciousness in trauma patients. However, a systemic evaluation scale specially in patients with multiple trauma is so important. The revised Acute Physiology and Chronic Health Evaluation system type 2 (APACHE II) is a physiologically based system including physiological variables. This study compares the efficacy of the predicting power for mortality and functional outcome of GCS and APACHEII in patients with multiple trauma in intensive care unit.
  
  
  METHODS
  This study included the patients with head injury associated with systemic trauma admitted in the ICU of Shahid Rajaee Hospital in 2007 and 2008. Sensitivity, specificity and correct prediction of outcome by GCS and APACHE II were assessed and compared.
  
  
  RESULTS
  This study included 93 patients (79 males, 14 females; mean age 60.5; range 14 to 87 years) with head injury associated with systemic trauma in 2007 and 2008. Mortality increased in the elderly group. The mean survival score using APACHE II was 36.5 and death score was 67.4 . These values using GCS were 10.3 and 6.8, respectively.
  
  
  CONCLUSIONS
  For the assessment of mortality, the GCS score still provides simple, less-time consuming and effective information concerning head injury patients, especially in emergencies; however, for the prediction of mortality in patients with multiple trauma. APACHE II is superior to GCS since it includes the main physiologic parameters of patients.
authors.affiliation: Neurosurgery Research Center of Shohada Tajrish Hospital, Shahid Beheshti University of Medical SciencesTehran, Iran.
authors.forename: Ali Reza
authors.initials: AR
authors.lastname: Zali
authors.forename: Amir Saied
authors.initials: AS
authors.lastname: Seddighi
authors.forename: Afsoun
authors.initials: A
authors.lastname: Seddighi
authors.forename: Farzad
authors.initials: F
authors.lastname: Ashrafi
mesh_terms: D018806:APACHE; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D006259:Craniocerebral Trauma; D005260:Female; D005544:Forecasting; D015600:Glasgow Coma Scale; D017052:Hospital Mortality; D006801:Humans; D007362:Intensive Care Units; D007492:Iran; D008297:Male; D008875:Middle Aged; D009493:Neurosurgery; D011237:Predictive Value of Tests; D012372:ROC Curve; D055815:Young Adult