Comparison of Glasgow Coma Scale (GCS) and National Early Warning Score (NEWS) in terms of mortality, morbidity, and safe discharge in adult patients presenting to the emergency department with head trauma: A retrospective observational study

Authors : Erkan Boğa

Pages : 587-593

View : 40 | Download : 131

Publication Date : 2026-01-01

Article Type : Research Paper

Abstract :Abstract Introduction and Aim: The research evaluated how the Glasgow Coma Scale (GCS) and National Early Warning Score (NEWS) systems perform in predicting death rates and disease severity and safe release outcomes for adult patients with isolated head injuries. Materials and Methods: The research used a retrospective observational design at Esenyurt Necmi Kadıoğlu State Hospital during 2024. The research included adult patients (≥18 years) with isolated head trauma who received documented GCS and NEWS scores. The study excluded patients who experienced multiple traumas and required CPR or were pregnant or had incomplete medical records. The research used logistic regression and sensitivity analysis to evaluate demographic and clinical and radiological and outcome data. Results and Conclusion: The research included 1000 patients who met the selection criteria after screening 1250 participants. The patients had an average age of 45.2 ± 18.7 years while males made up 58% of the total population. The death rate reached 10% while 20% needed ICU admission and 50% received safe hospital discharge. The NEWS system demonstrated better predictive capabilities for mortality (OR=2.1; 95% CI: 1.6–2.8; p<0.001) than the GCS (OR=1.5; 95% CI: 1.2–2.0; p=0.002). The combination of NEWS ≥7 and GCS ≤8 scores indicated that patients needed ICU admission. The prediction of safe discharge through NEWS ≤4 reached 90% accuracy. The predictive ability of GCS and NEWS together reached 0.87 (95% CI: 0.82–0.91) for determining patient outcomes. The NEWS system demonstrates better performance than GCS does in forecasting death rates and safe release outcomes for patients with mild head injuries. The GCS system continues to provide essential evaluation for patients with severe conditions. The joint application of NEWS and GCS enhances emergency clinical decision-making processes. Future research should include prospective multi-center studies.
Keywords : Head Trauma, Glasgow Coma Scale, National Early W arning Score, Mortality, ICU Admission, Safe Discharge

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