Mortality of Road Traffic Injured Patients Admitted to a Hospital in Isfahan, Iran, Using the GAP Scoring System
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Summary
This study evaluates the predictive accuracy of the Glasgow Coma Scale, Age, and Systolic Blood Pressure (GAP) scoring system for mortality among road traffic injury patients in Isfahan, Iran. Motivated by the high burden of road traffic accidents in developing countries and the need for rapid, reliable triage tools, the research aims to determine if the GAP score can effectively predict short-term and long-term mortality in trauma patients. The GAP system is noted for its simplicity, requiring only three easily accessible clinical parameters, making it suitable for pre-hospital and emergency settings. The researchers conducted a cross-sectional study using existing medical records from Ayatollah Kashani Hospital. The initial population included 2,674 road traffic injured patients transferred by emergency medical services between November 2019 and January 2020. After excluding cases with incomplete records, 1,985 patients were included in the final analysis. Data collection involved extracting demographic information, Glasgow Coma Scale (GCS) scores, systolic blood pressure (SBP), and accident mechanisms. The GAP score was calculated based on specific criteria: GCS (3–15 points), age (3 points if <60 years, 0 if >60), and SBP (6 points if >120 mmHg, 4 if 60–120 mmHg, 0 if <60 mmHg). Patients were categorized into high-risk (score 3–10), moderate-risk (11–18), and low-risk (19–24) groups. Mortality outcomes were assessed at 24 hours and 4 weeks post-injury. Statistical analysis included descriptive statistics and receiver operating characteristic (ROC) curve analysis to evaluate sensitivity, specificity, and the area under the curve (AUC). The results indicated that 14 patients (0.7% of the cohort) died during the study period. The majority of deaths occurred in the high-risk group, with 4 deaths (21% of that group) compared to 7 in the moderate-risk group (1%) and 3 in the low-risk group (1%). The GAP score demonstrated strong predictive power, with an AUC of 0.96 for 24-hour mortality and 0.94 for 4-week mortality. The optimal cut-off point for predicting short-term (24-hour) mortality was identified as 15, yielding a sensitivity of 96%. For long-term (4-week) mortality, the best cut-off was 18.22 with a sensitivity of 94%. The study also found that motorcyclists and pedestrians were disproportionately represented among the deceased, and head injuries were the most common cause of death. The study concludes that the GAP scoring system is a highly accurate, simple, and effective tool for predicting mortality in road traffic injury patients. Its high sensitivity and ease of calculation make it superior to more complex scoring systems for rapid clinical decision-making and triage. The findings support the implementation of the GAP score in emergency settings to prioritize care for high-risk patients. The authors recommend establishing a standardized registry system in Iran to improve data collection and tracking of trauma outcomes from the scene of the accident through hospital discharge.
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| Stage | Outcome | Tool | Model | Prompt | Attempts | Completed |
|---|---|---|---|---|---|---|
| discover | success | Crossref | — | — | 1 | 2026-06-20 |
| archive | success | canonical_url | — | — | 1 | 2026-06-26 |
| extract | success | cached | — | — | 2 | 2026-06-26 |
| clean | success | clean | — | — | 1 | 2026-06-20 |
| chunk | success | chunk | — | — | 1 | 2026-06-20 |
| embed | success | embed | Qwen/Qwen3-Embedding-8B | — | 1 | 2026-06-20 |
| enrich | success | openalex | — | — | 1 | 2026-06-20 |
| promote | success | — | — | — | 1 | 2026-06-20 |
| summarize | success | llm | qwen3.6-27b-prismaquant | summ-v5 | 1 | 2026-06-26 |
| tag | success | vector_similarity | — | — | 6 | 2026-06-20 |
| verify | success | — | — | — | 1 | 2026-06-26 |
Summary generated by qwen3.6-27b-prismaquant on 2026-06-26; verification: verified.
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