Glasgow Coma Scale, Revised Trauma Score, quick Sequential Organ Failure Assessment Score and the Modified Early Warning Score to predict the 7-day in-hospital mortality in patients with traumatic brain injury: a retrospective cohort study.

AIM: This study aimed to compare the prognostic performance of MEWS, GCS, RTS, and qSOFA in predicting 7-day in-hospital mortality among hospitalized patients with traumatic brain injury (TBI).

METHODS

This retrospective cohort study analyzed medical data of patients with TBI in a tertiary hospital in Changde City, China, from January 2023 to December 2023. The MEWS, GCS, RTS, and qSOFA were calculated based on vital signs, and the main outcome was 7-day in-hospital mortality. The area under the curve (AUC) of the receiver operating characteristic curve (ROC) was calculated to compare the prognostic performances of the MEWS, GCS, RTS, and qSOFA in predicting 7-day in-hospital mortality. A multivariate logistic regression model was used to determine factors independently associated with 7-day in-hospital mortality.

RESULTS

A total of 2519 patients were included, among whom 581 died within 7 days (23.1% of the cohort). The AUCs of the MEWS, GCS, qSOFA, and RTS were 0.87 (95% confidence interval (CI), 0.85–0.89), 0.57 (95% CI: 0.54–0.60), 0.66 (95% CI: 0.63–0.69), and 0.69 (95% CI: 0.66–0.71), respectively, with the MEWS showing the highest AUC. The following factors were independently associated with 7-day in-hospital mortality: MEWS (P < 0.001), RTS (P < 0.001), GCS (P < 0.001), qSOFA (P < 0.001), respiratory rate (RR) (P < 0.001), Temperature (P < 0.001), and Platelets (P = 0.030).

CONCLUSION

Our study showed that MEWS outperformed the other three indicators in predicting 7-day in-hospital mortality among Chinese patients with TBI and should be prioritized in clinical practice to identify high-risk populations and guide proactive interventions.