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Evaluation of the Glasgow coma scale score in critically Ill infectious disease patients

Evaluierung der Glasgow Coma Skala bei schwerkranken Patienten mit Infektionen

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Summary

In this prospective study the Glasgow Coma Scale (GCS) score was evaluated in 107 critically ill infectious disease (ID) patients admitted to the Intensive Care Unit (ICU) during a 1-year period. Patients were separated into two groups: those affected by central nervous system (CNS) infections and those affected by infections other than of the CNS. There were no apparent differences in the first ICU day GCS score values between the two groups (11±4 vs. 11±4, p=0.5318). Univariate logistic regression analysis confirmed a significant relationship between the first ICU day GCS score and the subsequent ICU mortality in the group of patients with CNS infections (r=0.3152, p=0.0015) but not in the group with infections not affecting the CNS (r=0.0919, p=0.1106). Our preliminary results suggest that the prognostic value of the GCS score is valid only in patients with CNS infections but not in other ID patients.

Zusammenfassung

Die Glasgow Coma Scale (GCS) wurde bei 107 schwerkranken Patienten mit Infektionen im Rahmen einer prospektiven Studie evaluiert. Es handelte sich um Patienten, die während eines Jahres in der Intensivpflegestation behandelt wurde. Sie wurden nach dem Vorliegen oder nicht Vorliegen einer Infektion des Zentralnervensystems in zwei Gruppen eingeteilt. In den GCS-Scores am ersten Tag der Intensivpflegebehandlung wiesen die beiden Gruppen keine Unterschiede auf (11±4 und 11±4; p=0,5318). Die logistische Regressionsanalyse für eine Variable deckte eine signifikante Beziehung zwischen dem GCS Punktewert am ersten Tag und der folgenden Sterberate bei Patienten mit ZNS-Infektionen auf (r=0,3152; p=0,0015). Bei Patienten, deren Infektion das ZNS nicht betraf, war eine derartige Beziehung nicht zu erkennen (r=0,0919; p=0,1106). Diese vorläufigen Ergebnisse lassen darauf schließen, daß der Glasgow Coma Score nur bei Patienten mit ZNS-Infektionen eine valide Funktion hat, nicht aber bei Patienten mit anderen Infektionen.

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Authors and Affiliations

  1. University Hospital for Infectious Diseases, “dr Fran Mihaljević”, Mirogojska 8, HR-10000, Zagreb, Croatia

    B. Baršić M.D., Ph.D., E. Marton M.D., J. Himbele M.D. & Ž. Ravlić M.D.

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  1. B. Baršić M.D., Ph.D.
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  2. E. Marton M.D.
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  3. J. Himbele M.D.
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  4. Ž. Ravlić M.D.
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Baršić, B., Marton, E., Himbele, J. et al. Evaluation of the Glasgow coma scale score in critically Ill infectious disease patients. Infection 24, 297–300 (1996). https://doi.org/10.1007/BF01743364

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