Effect of Glasgow Coma Scale Score on 28-Day Mortality in Patients with Acute Respiratory Distress Syndrome: A Multi-center Retrospective Study Based on the eICU Collaborative Research Database

Abstract

Abstract Objectives To determine the effect of the Glasgow Coma Scale (GCS) score on 28-day mortality in patients with acute respiratory distress syndrome (ARDS). Methods ARDS patients were enrolled from the eICU-CRD and stratified into survival and death groups based on 28-day survival.The primary predictor was the GCS score, which incorporates component scores for eyes, verbal, and motor responses, and a severity score (mild: 13-15, moderate: 9-12, severe: 3-8). A binary logistic regression model was developed using a random allocation of 2/3 patients as the modelling group and the remaining 1/3 as the internal validation group, and our model was externally validated using data from the Affiliated Hospital of Yunnan University. Results A total of 10,371 patients met the eligibility criteria, with a 28-day mortality rate of 27.4%. Our risk prediction model incorporated 12 variables, and the AUC for discrimination in the modeling, internal validation and external validation groups was 0.81 (95% CI, 0.79-0.82), 0.80 (95% CI, 0.78-0.81) and 0.80 (95% CI, 0.71-0.88), respectively, indicating favorable discrimination and calibration (Hosmer-Lemeshow P=0.466). Conclusions Our study revealed that the individual components of the GCS (verbal, eyes, motor) and the severity score (mild, moderate, severe) demonstrated comparable predictive effects to the total GCS score.