# Limited Accuracy of Mechanism, Glasgow Coma Scale, Age, And Pressure (MGAP) in Polytraumatic Patients: A Cross-sectional Study: -

## TL;DR

This study compares the accuracy of two trauma severity scores, ISS and MGAP, in predicting patient outcomes and finds ISS to be more reliable.

## Contribution

The study evaluates and contrasts the predictive performance of ISS and MGAP in polytraumatic patients, revealing limitations in MGAP's accuracy.

## Key findings

- ISS demonstrated high positive triage accuracy (98.18%) and low mislabeling rate.
- MGAP had a significantly lower positive triage accuracy (32.75%) and higher mislabeling rate (6.30%).
- MGAP's performance suggests it may not be universally applicable for risk stratification in trauma patients.

## Abstract

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.