Comparative Evaluation of Glasgow Coma Score and Gag Reflex in Predicting Aspiration Pneumonitis in Acute Poisoning Publisher Pubmed



Eizadimood N¹ ; Saghaei M¹ ; Alfred S² ; Zargarzadeh AH¹ ; Huynh C² ; Gheshlaghi F¹ ; Yaraghi A¹ ; Saad YS¹ Show Affiliations
Source: Journal of Critical Care Published:2009

Abstract

Purpose: The purpose of the study was to assess the incidence of aspiration pneumonitis (AP) and its association with gag reflex and Glasgow Coma Score (GCS). Materials and Methods: In a retrospective analysis study after prospective data collection, 155 poisoned patients with GCS less than or equal to 12 were evaluated. An assessment of GCS and the quality of gag reflex was made on arrival and recorded. Intubation status before gastrointestinal decontamination was noted. All patients were subsequently followed for developing of AP. Results: The incidence of AP was 15.5%, with significant variance among patients with respect to the gag reflex, GCS, and the performance of intubation. A logistic regression model for predicting AP contained the following predictors: GCS (odds ratio [OR], 0.43; 95% confidence interval [CI], 0.30-0.62), intubation (OR, 0.07; 95% CI, 0.01-0.49), organophosphate ingestion (OR, 1.39; 95% CI, 0.96-2.01), and gastric evacuation (OR, 4.29; 95% CI, 0.94-9.51). In patients with reduced gag reflex, variations in GCS were associated with AP (OR, 0.43; 95% CI, 0.20-0.90), whereas in patients with absent gag reflex, age was the most important predictor of AP (OR, 2.67; 95% CI, 0.99-7.22). Conclusions: A reduced GCS and a nonintubated trachea are associated with an increased incidence of AP. © 2009 Elsevier Inc. All rights reserved.