Comparison of four severity scores in patients with head trauma

This study examines the performance of four severity scores in a group of 70 consecutive patients with head trauma, hospitalized in the same neurosurgical ICU. On day of admission to the ICU, data were collected from each patient to compute Acute Physiology Score (APS), Simplified Acute Physiology Score (SAPS), Glasgow Coma Scale (GCS), and Therapeutic Intervention Scoring System (TISS). These four scores were statistically correlated with the outcome of patients. Results also indicate that GCS was superior to any other score in predicting outcome of patients and allowed better specificity and sensitivity. Regarding the level of care needed by patients, TISS was superior to any other scoring system. The difficulty in estimating individual prognosis is discussed, since scoring systems are aimed at classifying groups of patients, not individuals. It is concluded that GCS is a simpler and less time consuming method in predicting outcome of patients with head trauma.