Validation of a new coma scale, the FOUR score, in the emergency department.
نویسندگان
چکیده
OBJECTIVE Full Outline of Unresponsiveness (FOUR) score has previously been validated scale in the Neurosciences Intensive Care Unit. In this study, we sought to validate the use of FOUR score in the emergency department (ED) using non-neurology staff. We also compared its performance to the Glasgow Coma Scale (GCS) and correlated it to functional outcome at hospital discharge and overall survival. METHODS We prospectively rated 69 patients with initial neurologic symptoms presenting to the ED. Three types of examiners performed the FOUR score: ED physician, ED resident, and ED nurse. Patients were followed through hospital discharge; functional outcome was measured using modified Rankin Score (mRS). RESULTS Interrater reliability for FOUR score and GCS was excellent (respectively, kappa(w) = 0.88 and 0.86). Both FOUR score and GCS predicted functional outcome, and overall survival with and without adjustment for age, sex, and alertness group. CONCLUSION The FOUR score can be reliably used in the ED by non-neurology staff. Both FOUR score and GCS performed equally well, but the neurologic detail incorporated in the FOUR score makes it more useful in management and triage of patients.
منابع مشابه
بررسی پایایی مقیاس FOUR اصلی و اصلاح شده بر بیماران بستری شده در بخش مراقبت های ویژه
Background: The assessment of comatose patients is an important part of critical care. Few of the many available coma scales have gained wide spread approval and popularity. The best known and widely accepted scale is the Glasgow Coma Scale (GCS). The newer FOUR score (Full Outline of Un Responsiveness) provides an attractive replacement for all patients with fluctuating levels of cons...
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Revised trauma scoring system to predict in-hospital mortality in the emergency department: Glasgow Coma Scale, Age, and Systolic Blood Pressure score
INTRODUCTION Our aim in this study was to assess whether the new Glasgow Coma Scale, Age, and Systolic Blood Pressure (GAP) scoring system, which is a modification of the Mechanism, Glasgow Coma Scale, Age, and Arterial Pressure (MGAP) scoring system, better predicts in-hospital mortality and can be applied more easily than previous trauma scores among trauma patients in the emergency departmen...
متن کاملPredicting the outcome in children with head trauma: comparison of FOUR score and Glasgow Coma Scale.
BACKGROUND Because of the limitations of the Glasgow Coma Scale (GCS), many scoring systems have emerged and been compared with GCS. Herein, we investigated whether the Full Outline of Unresponsiveness (FOUR) score is better than GCS in predicting morbidity and mortality in children with head trauma. METHODS Patients 2-17 years of age who admitted to the emergency department with head trauma ...
متن کاملJugular bulb oxygen saturation correlates with Full Outline of Responsiveness score in severe traumatic brain injury patients
BACKGROUND Maintaining brain oxygenation status is the main goal of treatment in severe traumatic brain injury (TBI). Jugular venous oxygen saturation (SjvO2) monitoring is a technique to estimate global balance between cerebral oxygen supply and its metabolic requirement. Full Outline of Responsiveness (FOUR) score, a new consciousness measurement scoring, is expected to become an alternative ...
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عنوان ژورنال:
- Neurocritical care
دوره 10 1 شماره
صفحات -
تاریخ انتشار 2009