Key result
The FOUR score demonstrated equivalent interrater reliability to the Glasgow Coma Scale for evaluating the neurological status of intensive care unit patients, with no significant differences among raters.
Why the study?
Does the FOUR score provide better or equivalent interrater reliability compared to the GCS in evaluating the neurological status of ICU patients?
Observational (n=105)
Single-blind
No
Does the FOUR score provide better or equivalent interrater reliability compared to the GCS in evaluating the neurological status of ICU patients?
The FOUR score is at least equivalent to the GCS in terms of interrater reliability and ease of use for evaluating the neurological status of ICU patients.
Objective: The Glasgow Coma Scale (GCS) is the most widely used scoring system to evaluation of neurological status for patients in intensive care unit. Limitations of the GCS include severe to assess the verbal score in intubated or aphasic patients. The Full Outline of UnResponsiveness score (FOUR), a new coma scale not reliant on verbal response, was recently proposed. New scales strongly suggest a scale is needed that could provide further nerological detail that is easy to use. We aimed to compare FOUR score and GCS among unselected patients in intensive care units and comparerealibility betweenobservers.Material-Methods: In our study 105 patients was admitted. Three different types of examiners tested FOUR score and GCS: one intensive care unit nurse, one anaesthesiology resident (2. year), and one anaesthesiology fellow. Patients receiving sedative agents or neuromuscular function blockers were excluded. The raters performed their examination within 1 hour of each other without knowledge of the others scores.Results: In our study compared the interrater agreement of GCS and FOUR score. Although FOUR score was thought to be superior in aphasic and intubated patients, there was neither a statistical significant difference between the GCS and the FOUR score nor a difference among ICU staff.Conclusion: As a result, the scores that used in ICUs, should be simple, reliable and predictive. Our study revealed that the FOUR score is at least equivalent to the GCS. And for us, GCS and FOUR scores are easy to use both doctors and nurses.
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Şahin et al. (2015) conducted an observational in Altered neurological status in intensive care (n=105). FOUR score vs. Glasgow Coma Scale (GCS) was evaluated on Interrater agreement and score differences among ICU staff (p=0.80). The FOUR score demonstrated equivalent interrater reliability to the Glasgow Coma Scale for evaluating the neurological status of intensive care unit patients, with no significant differences among raters.
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