Limited Accuracy of Mechanism, Glasgow Coma Scale, Age, And Pressure (MGAP) in Polytraumatic Patients: A...

Trauma, an external assault's corporeal aftermath, manifests as wounds or injuries, breaching or not breaching the skin, wrought by environmental forces upon the human, and is considered One of the world's foremost public health challenges intertwines complex societal, environmental, and medical issues. In order to evaluate the severity of trauma, it seems necessary to have a quantitative scale that can be measured. Therefore, the aim of this study is to look into the predictive power of two scoring indices, The Injury Severity Score (ISS) and MGAP, in patients with multiple traumas.

This research is a cross-sectional type and was conducted on trauma patients, aged 18 and over, with at least two traumas, hospitalized for over 24 hours in Taleghani Hospital in Mashhad in the period of one year from October 2020 to October 2021. For ISS, the Abbreviated Injury Scale (AIS) scores for affected organs in six body areas were determined, and the three highest AIS scores were calculated. For the MGAP score, data on injury mechanism, age, Glasgow Coma Scale (GCS), and systolic blood pressure were extracted. A chi-square test was conducted to ascertain the correlations between categorical variables and the status of survival. Additionally, Positive Triage Accuracy was measured and compared for ISS and MGAP.

In this research, 699 cases were investigated. Among the patients, 567 (81%) were male and 132 (19%) were female. Also (92%) 641 patients were discharged alive and (8%) 58 patients died. Among the 114 patients admitted to the ICU, 45 (39%) died. Cases mislabeled as medium or low risk that experienced death happened in 7 cases (of 598 available records; 1.17%) based on the ISS risk stratification system with 98.18% Positive Triage Accuracy and 44 cases (of 698 available records; 6.30%), based on the MGAP risk stratification system with 32.75% positive triage accuracy.

The findings show the robust predictive power of ISS, with a low mislabeling rate and high triage accuracy. Conversely, the MGAP system demonstrated a higher mislabeling rate, suggesting that its application may yield incorrect results in certain situations and settings. This shows the need for cautious consideration when applying the MGAP risk stratification system, as its performance may not be universally applicable across all scenarios.