Correlation between GCS and the risk of aspiration pneumonia in self-poisoning patients
Published: 21 March 2006
Keywords
Introduction
Self-poisoning is a common cause of nontraumatic coma, especially in young people. The management of these patients aims to protect the airway in order to prevent aspiration pneumonia (AP). Some author recommend to intubate when GCS < 8. However, only few studies have examined the relation between GCS, the caught reflex and the frequency of AP in self-poisoning patients (SPP). The aim of our study is to evaluate the relation between GCS and the risk of developing this complication.
Materials and methods
We conducted a retrospective study during 2004 including all admitted SPP in our ICU. GCS was noted on admission or immediately before intubation. The diagnosis of AP was performed according to the usual criteria. Two groups were compared: G1 (without AP) and G2 (with AP). Data were expressed as a mean ± SD and percentage. Tests used for comparisons were the Q square and Student t tests. The ROC curve was used to determinate the cutoff value of GCS associated to high risk of AP.
Results
(abstract P69)
G1 (n = 446) | G2 (n = 78) | P | |
|---|---|---|---|
Age | 27.8 ± 12.9 | 31.1 ± 12.8 | 0.036 |
Gender, female (%) | 67.2 | 55.1 | 0.04 |
IGS II | 18 ± 11 | 33 ± 11 | <0.001 |
APACHE II score | 6.8 ± 5.1 | 14.3 ± 4.8 | <0.001 |
SBP | 112 ± 19 | 105 ± 22 | 0.05 |
GCS | 12.7 ± 3.2 | 8.1 ± 3.2 | <0.001 |
MV (%) | 22 | 87 | <0.001 |
LOS (hours) | 44 ± 69 | 67 ± 71 | 0.006 |
Mortality (%) | 1.6 | 2.6 | 0.8 |
Conclusion
Criteria used for intubation in SPP must be more rigorous. According to our study, patients with GCS < 12 should be considered for intubation.
