Method and system for obtaining multiple clinical scores based on eye opening and motion response

Abstract

The invention discloses a method for obtaining a plurality of clinical scores based on eye opening and movement reactions. The method comprises the following steps: S1, obtaining an eye opening reaction score E and a movement reaction score M of a patient; s2, obtaining an eye opening-movement combination score C; mapping C into a language score V; s3, calculating a Grassland coma scale GCS (Grassland coma scale); s4, performing conversion score according to the GCS, and respectively calculating corresponding RTS, SOFA and OASIS; s5, generating each change trend chart; and S6, displaying each change trend chart, evaluating the current consciousness state of the patient, and generating suggestions and matters needing attention. According to the method, the standardized and high-reliability GCS score can be calculated only by observing the eye opening and movement of the patient and combining the mapping relation with the language condition; and based on the relevance with other clinical scores, other clinical scores are effectively obtained, and then the change trend chart is visually displayed, so that the state of the patient is conveniently evaluated.

Description

Technical Field

[0001] The present invention relates to the field of clinical information technology, and particularly relates to a method and system for obtaining multiple clinical scores based on eye opening and motor responses. Background Art

[0002] GCS, the full name is Glasgow Coma Scale. GCS, that is, the Glasgow Coma Scale, is an important tool widely used clinically to evaluate the consciousness level and neurological function of patients. The traditional GCS score includes three dimensions: eye opening response E, verbal response V, and motor response M. However, for intubated patients, since intubation itself hinders the patient from speaking, the verbal response cannot be directly evaluated, which results in the inability to obtain an accurate total GCS score clinically, and further affects the application of various clinical scoring systems that rely on GCS calculation, such as the Revised Trauma Score RTS, Sequential Organ Failure Assessment SOFA, the Acute Physiology and Chronic Health Evaluation for Intensive Care Unit Patients OASIS score, the Acute Physiology and Chronic Health Evaluation APACHE score, etc.

[0003] Currently, the main methods for dealing with the GCS score of intubated patients clinically are as follows: First, simply record it as "T" for intubation without assigning a specific score, and the result is relatively abstract, resulting in the inability to calculate the total GCS score; Second, hypothetically assign the lowest score of 1 point, underestimating the actual state of the patient; Third, hypothetically assign the previous highest score, which may overestimate the current state of the patient.

[0004] The above-mentioned methods all have obvious defects, unable to accurately reflect the neurological function state of intubated patients, and not conducive to standardized recording and calculation in the medical information system. The lack of an accurate total GCS score will directly affect clinical decision-making, patient prognosis assessment, and the judgment of disease severity. Although there are some studies attempting to solve this problem, there is currently no unified and standard method to accurately deduce the verbal score of intubated patients and calculate the total GCS score. This technical gap limits the accuracy of the assessment of critically ill patients and the rationality of clinical decision-making. Summary of the Invention

[0005] In view of the above problems, the object of the present invention is to propose a method and system for obtaining multiple clinical scores based on eye opening and motor responses. By only observing the eye opening response and motor response of the patient and combining with the mapping relationship with the language situation, a standardized and highly reliable GCS score can be calculated; at the same time, based on the correlation between the GCS score and other clinical scores, the scores of RTS, SOFA, and OASIS can be effectively obtained, and then intuitively displayed in a trend chart to facilitate the assessment of the patient's current state and treatment recommendations.

[0006] It is achieved through the following technical solutions: First, a method for obtaining multiple clinical scores based on eye opening and motor responses is proposed for the treatment of intubated patients, including the following steps: S1. Based on the eye opening response, obtain the eye opening response score E of the patient; based on the motor response, obtain the motor response score M of the patient. Both E and M are positive integers, where 1 ≤ E ≤ 4 and 1 ≤ M ≤ 6; S2. Add the eye opening response score E and the motor response score M in step S1 to obtain the eye-opening - motor combined score C. C is a positive integer and 2 ≤ C ≤ 10; map the numerical value of C to the language score V to characterize the patient's language condition. V is a positive integer and 1 ≤ V ≤ 5; S3. Based on the eye opening response score E, motor response score M in step S1, and the language score V in step S2, calculate the Glasgow Coma Scale GCS, where GCS = E + V + M; S4. Convert the Glasgow Coma Scale GCS in step S3 into the conversion score I of the Revised Trauma Score RTS, the conversion score II of the Sequential Organ Failure Assessment SOFA, and the conversion score III of the OASIS score respectively, and calculate the corresponding magnitudes of RTS, SOFA, and OASIS based on each conversion score; S5. Store the magnitudes of RTS, SOFA, and OASIS in step S4 and their respective timestamps in the database, and generate a time-based trend graph for each clinical score; S6. Display each of the trend graphs in step S5 respectively, and then evaluate the patient's current consciousness state based on the Glasgow Coma Scale GCS; generate treatment suggestions and precautions based on the magnitudes of RTS, SOFA, and OASIS in step S5.

[0007] Preferably, in step S1, E = 1 indicates no eye opening, E = 2 indicates eye opening in response to pain stimulation, E = 3 indicates eye opening in response to verbal stimulation, E = 4 indicates spontaneous eye opening; M = 1 indicates no motor response, M = 2 indicates extension response to pain stimulation, M = 3 indicates abnormal flexion in response to pain stimulation, M = 4 indicates withdrawal in response to pain stimulation, M = 5 indicates localization in response to pain stimulation, M = 6 indicates following commands.

[0008] Preferably, in step S2, when mapping the numerical value of C to the language score V, when 2 ≤ C ≤ 6, V = 1, corresponding to the situation of no language response; when C = 7, V = 2, corresponding to the situation of making meaningless sounds; when C = 8 or 9, V = 4, corresponding to the situation of confused speech; when C = 10, V = 5, corresponding to the situation of good speech orientation.

[0009] Preferably, when calculating the Revised Trauma Score (RTS) in step S4, obtain the systolic blood pressure score and the respiratory rate score of the patient, and calculate the RTS based on the systolic blood pressure score, the respiratory rate score, and the Glasgow Coma Scale (GCS) in step S3; RTS = 0.9368 × conversion score I + 0.7326 × systolic blood pressure score + 0.2908 × respiratory rate score; where, when the total score of GCS is 3, the conversion score I is 0; when the total score of GCS is 4 - 5, the conversion score I is 1; when the total score of GCS is 6 - 8, the conversion score I is 2; when the total score of GCS is 9 - 12, the conversion score I is 3; when the total score of GCS is 13 - 15, the conversion score I is 4.

[0010] Preferably, in step S4, when the total score of GCS is 15, the conversion score II is 0; when the total score of GCS is 13 or 14, the conversion score II is 1; when the total score of GCS is 10 - 12, the conversion score II is 2; when the total score of GCS is 6 - 9, the conversion score II is 3; when the total score of GCS is less than 6, the conversion score II is 4.

[0011] Preferably, in step S4, when the total score of GCS is 15, the conversion score III is 0; when the total score of GCS is 14, the conversion score III is 3; when the total score of GCS is 8 - 13, the conversion score III is 4; when the total score of GCS is 3 - 7, the conversion score III is 10.

[0012] Preferably, when generating treatment suggestions in step S6, if multiple clinical scores all decrease with the time stamp, give an alarm.

[0013] Also proposed is a system for obtaining multiple clinical scores based on eye opening and motor responses, which operates using the method described in any one of the above, and includes a patient information input area, a GCS score input area, a result display area, and a clinical analysis area; wherein, the patient information input area is used to record the personal information of the patient; the GCS score input area is used to input the eye opening response score E and the motor response score M of the patient; the result display area generates the language score V, the total score of GCS, and the scores corresponding to RTS, SOFA, and OASIS respectively based on the input content of the GCS score input area; the clinical analysis area generates the consciousness state and treatment suggestions of the patient based on the content displayed in the result display area.

[0014] Furthermore, also proposed is an electronic device, including a memory and a processor, the memory stores a computer program, and the processor is configured to execute the method described in any one of the above when running the computer program.

[0015] In addition, a storage medium is proposed, in which a computer program is stored. When the computer program runs in a processor, the processor executes the method described in any one of the above.

[0016] The beneficial effects of the present invention compared with the prior art are as follows: The technical solution of the present invention only needs to observe the patient's eye-opening response and motor response, and then combine with the mapping relationship with the language situation to calculate a standardized and highly reliable GCS score. At the same time, based on the correlation between the GCS score and other clinical scores, the scores of RTS, SOFA, and OASIS can be effectively obtained, and then intuitively displayed in a trend chart to facilitate the evaluation of the patient's current state and treatment suggestions. BRIEF DESCRIPTION OF THE DRAWINGS

[0017] Figure 1 is a flowchart of a method for obtaining multiple clinical scores based on eye-opening and motor responses; Figure 2 is a result diagram when a system for obtaining multiple clinical scores based on eye-opening and motor responses runs; Figure 3 is a flowchart of a derivation algorithm for a language score V. DETAILED DESCRIPTION OF THE EMBODIMENTS

[0018] Next, the technical solutions in the embodiments of the present invention will be described in detail in conjunction with the attached Figures 1 to 3 drawings in the embodiments of the present invention.

[0019] As Figure 1 shown, it is a flowchart of a method for obtaining multiple clinical scores based on eye-opening and motor responses. This method is applicable to patients who cannot be evaluated linguistically, such as intubated patients and patients with severe facial trauma, laryngeal injuries, and aphasia. Only by obtaining the patient's eye-opening response score and motor response score, the patient's multiple clinical scores can be accurately obtained according to a fixed calculation method, greatly simplifying the evaluation process and also overcoming problems such as hypothetical GCS scoring and the accuracy of abstract evaluation. The specific steps are as follows: S1. Based on the eye-opening response, obtain the patient's eye-opening response score E. E has a total of 4 levels, corresponding to 4 different eye-opening situations of the patient. Specifically, E = 1 means no eye opening, E = 2 means eye opening in response to painful stimuli, E = 3 means eye opening in response to verbal stimuli, and E = 4 means spontaneous eye opening. Scoring for the four different eye-opening situations effectively reflects the patient's four different physical conditions.

[0020] Then, based on the motor response, obtain the patient's motor response score M. M has 6 levels, corresponding to 6 different motor conditions of the patient, which also reflect the patient's current different physical motor ability conditions. Specifically, M = 1 indicates no motor response; M = 2 indicates an extensor response to pain stimulation, that is, corresponding to the decorticate state; M = 3 indicates abnormal flexion to pain stimulation, that is, corresponding to the decerebrate state; M = 4 indicates withdrawal in response to pain stimulation but inability to localize; M = 5 indicates the ability to localize in response to pain stimulation; M = 6 indicates the ability to follow commands to perform actions.

[0021] When scoring, it is necessary to verify the legality of E and M to ensure that the value range of E is 1 - 4, the value range of M is 1 - 6, and both are integers. If there is an error, the corresponding scoring needs to be redone, otherwise it will cause data problems in the subsequent processing process.

[0022] S2. Add the eye - opening response score E and the motor response score M in step S1 to obtain the eye - opening - motor combined score C. C is a positive integer and 2 ≤ C ≤ 10; map the numerical value of C to the language score V, which is used to characterize the patient's language situation. V is a positive integer and 1 ≤ V ≤ 5, respectively reflecting 5 different language situations of the patient. For patients who are unable to perform language behaviors such as intubated patients, when they are being treated, they will still have corresponding eye reactions or body movements, which can all represent what the patient wants to express. Deriving the language score through the E + M score can effectively evaluate the patient's tendency to speak and the current neurological function state.

[0023] As Figure 3 shown, it is a flowchart of the derivation algorithm for the language score V. After deriving the language score V, it can be used to calculate the total Glasgow Coma Scale (GCS). In the figure, Sum represents summation, and the result of Sum is the value of C. When mapping the numerical value of C to the language score V, when 2 ≤ C ≤ 6, V = 1, corresponding to the situation of no language response; when C = 7, V = 2, corresponding to the situation of making meaningless sounds; when C = 8 or 9, V = 4, corresponding to the situation of confused speech; when C = 10, V = 5, corresponding to the situation of well - oriented speech.

[0024] S3. Based on the eye - opening response score E, motor response score M in step S1 and the language score V in step S2, calculate the Glasgow Coma Scale (GCS). GCS = E + V + M. In this way, the value range of the obtained GCS is 3 - 15, which is consistent with the traditional standard GCS scoring range, thus maintaining the standardization, generalization and clinical practicality of the scoring.

[0025] S4. Convert the Glasgow Coma Scale (GCS) in step S3 into the conversion score I of the Revised Trauma Score (RTS), the conversion score II of the Sequential Organ Failure Assessment (SOFA), and the conversion score III of the OASIS score respectively. Then, calculate the corresponding magnitudes of RTS, SOFA, and OASIS based on each conversion score.

[0026] In this embodiment, when calculating the Revised Trauma Score (RTS) in step S4, obtain the systolic blood pressure score and the respiratory rate score of the patient. Based on the systolic blood pressure score, the respiratory rate score, and the Glasgow Coma Scale (GCS) in step S3, calculate the Revised Trauma Score (RTS); RTS = 0.9368 × conversion score I + 0.7326 × systolic blood pressure score + 0.2908 × respiratory rate score; where when the total score of GCS is 3, the conversion score I is 0; when the total score of GCS is 4 - 5, the conversion score I is 1; when the total score of GCS is 6 - 8, the conversion score I is 2; when the total score of GCS is 9 - 12, the conversion score I is 3; when the total score of GCS is 13 - 15, the conversion score I is 4.

[0027] Both the systolic blood pressure score and the respiratory rate score need to be measured by a monitor for the patient, and then converted into the corresponding scores respectively. For example, when the respiratory rate is greater than 29 times / min, 10 - 29 times / min, 6 - 9 times / min, 1 - 5 times / min, 0 times / min, they correspond to the respiratory rate scores 4, 3, 2, 1, and 0 respectively; when the systolic blood pressure is ≥90 mmHg, 76 - 89 mmHg, 50 - 75 mmHg, <50 mmHg, 0 mmHg, they correspond to the systolic blood pressure scores 4, 3, 2, 1, and 0 respectively. mmHg is the common unit of millimeters of mercury for blood pressure measurement.

[0028] In this embodiment, the Sequential Organ Failure Assessment (SOFA) effectively reflects the damage condition of the patient's nervous system. For the Sequential Organ Failure Assessment (SOFA), when the total score of GCS is 15, the conversion score II is 0; when the total score of GCS is 13 or 14, the conversion score II is 1; when the total score of GCS is 10 - 12, the conversion score II is 2; when the total score of GCS is 6 - 9, the conversion score II is 3; when the total score of GCS is less than 6, the conversion score II is 4. The Sequential Organ Failure Assessment (SOFA) mainly quantifies the organ failure situation by evaluating the functional damage degrees of 6 organ systems including respiration, coagulation, liver, circulation, nerve, and kidney. GCS corresponds to the degree of nerve damage. By obtaining the conversion score II through the total score of GCS, it can be accurately applied to the Sequential Organ Failure Assessment (SOFA).

[0029] In this embodiment, for the OASIS score, when the total score of the GCS is 15, the conversion score III is 0; when the total score of the GCS is 14, the conversion score III is 3; when the total score of the GCS is 8 - 13, the conversion score III is 4; when the total score of the GCS is 3 - 7, the conversion score III is 10. The OASIS score is used to predict the patient's risk of death by evaluating multiple variables, where the multiple variables include age, type of admission, GCS, heart rate, mean arterial pressure, respiratory rate, body temperature, urine output, and oxygenation status. Here, obtaining the conversion score III based on the total score of the GCS can be used in the OASIS score.

[0030] S5. Store the magnitudes of RTS, SOFA, and OASIS and their respective timestamps in step S4 in the database, and generate a time-based change trend graph for each clinical score, thereby realizing continuous monitoring and trend analysis of the change in the patient's consciousness state, which is convenient for intuitively understanding the development of the patient's condition.

[0031] S6. Display each change trend graph in step S5 respectively, and then evaluate the patient's current consciousness state according to the Glasgow Coma Scale (GCS), such as normal, mildly impaired, moderately impaired, severely impaired, etc. Then, generate treatment suggestions and precautions based on the magnitudes of RTS, SOFA, and OASIS in step S5. For example, evaluate the GCS score every 2 hours; another example is to maintain airway patency and ensure appropriate oxygenation, etc.

[0032] In this embodiment, the lower the GCS score, the more serious the patient's condition, while the higher the scores of RTS, SOFA, and OASIS, the more serious the patient's condition. Therefore, when generating treatment suggestions, if it is found that these clinical scores of RTS, SOFA, and OASIS all increase with the timestamp, early warning needs to be given in a timely manner.

[0033] As Figure 2 shown, it is a result graph during the operation of a system for obtaining multiple clinical scores based on eye opening and motor responses. The eye movement response in the graph is the eye opening response. The system mainly includes a patient information input area, a GCS score input area, a result display area, and a clinical analysis area. Just input the eye opening response score and the motor response score, and corresponding results or suggestions can be automatically generated.

[0034] The patient information input area is used to record the personal information of the patient, such as ID, name, gender, age, bed number, assessor, admission time, assessment time, and so on. The GCS score input area is used to input the eye opening response score E and motor response score M of the patient. The result display area generates the language score V, the total score of GCS, and the scores corresponding to RTS, SOFA, and OASIS respectively based on the input content in the GCS score input area. The clinical analysis area generates the consciousness state and treatment suggestions of the patient based on the content displayed in the result display area.

[0035] Furthermore, an electronic device is also proposed, which includes a memory and a processor. The memory stores a computer program, and the processor is configured to execute the method described in any one of the above when running the computer program.

[0036] In addition, a storage medium is also proposed. The storage medium stores a computer program, and when the computer program runs in the processor, the processor executes the method described in any one of the above.

[0037] In summary, the present invention only needs to observe the eye opening response and motor response of the patient, and then combine with the mapping relationship with the language situation to calculate the standardized and highly reliable GCS score; at the same time, based on the correlation between the GCS score and other clinical scores, the scores of RTS, SOFA, and OASIS can be effectively obtained, and then intuitively displayed in a trend chart, which is convenient for evaluating the current state of the patient and generating treatment suggestions, and has significant progressiveness.

[0038] The above embodiments are only used to illustrate the technical idea of the present invention, and the protection scope of the present invention cannot be limited thereby. Any modification made on the basis of the technical solution according to the technical idea proposed by the present invention falls within the protection scope of the present invention.

Claims

1. A method for obtaining multiple clinical scores based on eye opening and motor response for treating endotracheal intubated patients, characterized in that: The steps include: S1. Based on the eye opening reaction, obtain the patient's eye opening reaction score E; based on the movement reaction, obtain the patient's movement reaction score M, where E and M are both positive integers, 1≤E≤4, 1≤M≤6; S2, adding the eye opening response score E and the movement response score M in step S1 to obtain the eye opening-movement combined score C, where C is a positive integer and 2≤C≤10; mapping the value of C to a language score V, which is used to characterize the patient's language condition, where V is a positive integer and 1≤V≤5; S3, based on the eye opening reaction score E, the motor reaction score M in step S1 and the language score V in step S2, calculate the Glasgow Coma Scale GCS, GCS=E+V+M; S4, converting the Glasgow Coma Scale GCS in step S3 into conversion score I of the modified trauma score RTS, conversion score II of the sequential organ failure assessment SOFA, and conversion score III of the OASIS score, and calculating the corresponding RTS, SOFA, and OASIS according to each conversion score; S5, storing the sizes of RTS, SOFA and OASIS in step S4 and their corresponding timestamps in a database, and generating a time-based trend graph of each clinical score; S6. Display each change trend graph in step S5 respectively, and then evaluate the patient's current state of consciousness based on the Glasgow Coma Scale GCS; generate treatment recommendations and precautions based on the sizes of RTS, SOFA and OASIS in step S5.

2. A method for obtaining multiple clinical scores based on eye opening and movement response according to claim 1, characterized in that: In step S1, E=1 indicates that the eyes are not opened, E=2 indicates that the eyes are opened to painful stimulation, E=3 indicates that the eyes are opened to verbal stimulation, and E=4 indicates that the eyes are opened automatically; M=1 indicates no motor response, M=2 indicates that there is an extension response to painful stimulation, M=3 indicates that there is abnormal flexion to painful stimulation, M=4 indicates that the eyes are retracted to painful stimulation, M=5 indicates that the painful stimulation can be located, and M=6 indicates that the action is performed as instructed.

3. A method for obtaining multiple clinical scores based on eye opening and movement response according to claim 1, characterized in that: In step S2, when the numerical value of C is mapped to a language score V, when 2≤C≤6, V=1, corresponding to a situation where there is no language response; when C=7, V=2, corresponding to a situation where meaningless sounds are made; when C=8 or 9, V=4, corresponding to a situation where the speech is confused; when C=10, V=5, corresponding to a situation where the speech orientation is good.

4. A method for obtaining multiple clinical scores based on eye opening and movement response according to claim 1, characterized in that: When calculating the modified trauma score RTS in step S4, the systolic blood pressure score and respiratory rate score of the patient are obtained, and the modified trauma score RTS is calculated based on the systolic blood pressure score, the respiratory rate score and the Glasgow Coma Scale GCS in step S3; RTS=0.9368×conversion score I+0.7326×systolic blood pressure score+0.2908×respiratory rate score; wherein, when the total score of GCS is 3, the conversion score I is 0; when the total score of GCS is 4-5, the conversion score I is 1; when the total score of GCS is 6-8, the conversion score I is 2; when the total score of GCS is 9-12, the conversion score I is 3; when the total score of GCS is 13-15, the conversion score I is 4.

5. A method for obtaining multiple clinical scores based on eye opening and movement response according to claim 1, characterized in that: In step S4, when the total score of GCS is 15, the conversion score II is 0; when the total score of GCS is 13 or 14, the conversion score II is 1; when the total score of GCS is 10-12, the conversion score II is 2; when the total score of GCS is 6-9, the conversion score II is 3; when the total score of GCS is less than 6, the conversion score II is 4.

6. A method for obtaining multiple clinical scores based on eye opening and movement response according to claim 1, characterized in that: In step S4, when the total score of GCS is 15, the conversion score III is 0; when the total score of GCS is 14, the conversion score III is 3; when the total score of GCS is 8-13, the conversion score III is 4; when the total score of GCS is 3-7, the conversion score III is 10.

7. A method for obtaining multiple clinical scores based on eye opening and movement response according to claim 1, characterized in that: When generating treatment recommendations in step S6, if multiple clinical scores decrease with the timestamp, an early warning is issued.

8. A system for obtaining multiple clinical scores based on eye opening and movement response, operating using the method as described in any one of claims 1 to 9 above, characterized in that: It includes patient information input area, GCS score input area, result display area and clinical analysis area; Among them, the patient information input area is used to record the patient's personal information; the GCS score input area is used to input the patient's eye opening reaction score E and motor reaction score M; the result display area generates the language score V, the total score of GCS, and the corresponding scores of RTS, SOFA and OASIS based on the input content of the GCS score input area; the clinical analysis area generates the patient's consciousness state and treatment recommendations based on the content displayed in the result display area.

9. An electronic device, characterized in that: The method comprises a memory and a processor, wherein the memory stores a computer program, and the processor is configured to execute the method according to any one of claims 1 to 7 when running the computer program.

10. A storage medium, characterized in that: The storage medium stores a computer program. When the computer program runs in a processor, the processor executes the method according to any one of claims 1 to 7.

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