LAUSR

Introduction/Hypothesis: The GCS was designed in the mid1970s to standardize the assessment and communication of neurologic change and consciousness. GCS has since been described as ranging from unreliable to improving outcome predictions. GCS has been incorporated as a significant risk factor for mortality in a number of ICU risk models. The study objective was to assess the value of admission GCS alone in predicting ICU mortality. Methods: Adult, non-traumatic ICU patients from 3 distinct tele-ICU programs, were evaluated during the study period. Patients who were missing a GCS or ventilation information within the first 6 hours of ICU admission were excluded. We extracted total GCS consisting of Eye Opening, Verbal and Motor Response as reported in the patient chart at 6 hours after ICU admission. The GCS was categorized based on the level of abnormality using predefined thresholds: No Abnormality (N: 14-15); Slight (Sl: 10-13); Moderate (M: 7-9); Severe (Sr: ⩽ 6). Each pts ICU disposition was recorded as survived or non-survived and correlated with their 6 hour GCS categorization, with statistical tests done using the Chi-square test. Results: Data were collected from three U.S. tele-ICU programs monitoring 624 beds continuously. Consecutive ICU admissions were archived for 72-85 days at each site from 10/2017 to 1/2018. There was a total of 5,322 pt stays (26.2% ventilated) with a mean age (SD) = 64.6 (15.5) yrs; 67.7% male. A total of 5,272 (99.1%) pts had a 6 hr GCS with 331 (6.3%) total deaths. Total number of pts based on categorization of GCS scores were: N: 4,119; Sl: 645; M: 263; Sr: 245. Total % (n) deaths based on the 6 hr GCS categorization was: N: 3.3% (137); Sl: 9.0% (58); M: 16.4% (43); Sr: 38.0% (93) (P<0.01). Conclusions: The 6 hr post ICU admission total GCS demonstrated significant delineation in correlating with ultimate ICU mortality.