Interrater Reliability and Predictive Validity of the FOUR Score Coma Scale in a Pediatric Population

2009 ◽  
Vol 41 (5) ◽  
pp. 268-269
Author(s):  
&NA;
Keyword(s):  
Predictive Validity ◽  
Interrater Reliability ◽  
Pediatric Population ◽  
Coma Scale ◽  
Four Score

scholarly journals The Criterion Validity, Reliability, and Feasibility of an Instrument for Assessing the Nursing Intensity in Perioperative Settings

2017 ◽  
Vol 2017 ◽  
pp. 1-9
Author(s):  
Satu Rauta ◽  
Sanna Salanterä ◽  
Tero Vahlberg ◽  
Kristiina Junttila
Keyword(s):  
Predictive Validity ◽  
Interrater Reliability ◽  
Criterion Validity ◽  
Classification Systems ◽  
Patient Classification ◽  
University Hospitals ◽  
Care Needs ◽  
Perioperative Nurses ◽  
Staff Allocation

Patient classification systems generate information for staff allocation based on a patient’s care needs. This study aims to test further the instrument for assessing nursing intensity (NI) in perioperative settings. Nine operating departments from five university hospitals were involved. The perioperative nurses gathered data from patients (N=876) representing different fields of surgery. Reliability was tested by parallel classifications (n=144). Also, the users’ (n=40) opinions were surveyed. The results support the predictive validity and interrater reliability of the instrument. The nurses considered the instrument feasible to use. The patients’ low ASA class did not automatically signify low NI; however, high ASA class was more frequently associated with high intraoperative NI. Intraoperative NI indicated the length of the postanaesthesia care and the type of the follow-up unit. Parallel classifications ensured the homogenous use of the instrument. The use of the instrument is recommended.

scholarly journals Validity of the FOUR Score Coma Scale in the Medical Intensive Care Unit

2009 ◽  
Vol 84 (8) ◽  
pp. 694-701 ◽  
Author(s):  
Vivek N. Iyer ◽  
Jayawant N. Mandrekar ◽  
Richard D. Danielson ◽  
Alexander Y. Zubkov ◽  
Jennifer L. Elmer ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Medical Intensive Care Unit ◽  
Coma Scale ◽  
Four Score ◽  
Medical Intensive Care

Missile injury to the pediatric brain in conflict zones

2011 ◽  
Vol 7 (3) ◽  
pp. 276-281 ◽  
Author(s):  
Abrar A. Wani ◽  
Altaf U. Ramzan ◽  
Nayil K. Malik ◽  
Abdul Qayoom ◽  
Furqan A. Nizami ◽  
...  
Keyword(s):  
Glasgow Coma Scale ◽  
Pediatric Population ◽  
Developed Countries ◽  
Multinomial Regression ◽  
Chi Square ◽  
Conflict Zones ◽  
Coma Scale ◽  
Hemodynamic Status ◽  
Missile Injury ◽  
Gcs Score

Object This study was conducted both prospectively and retrospectively at one center over a period of 8 years. The population consisted of all patients with both an age 18 years or younger and a diagnosed penetrating missile injury (PMI) during the study interval. The authors analyzed factors determining outcome and demographic trends in this population, and they compared them with those in the more developed world Methods Fifty-one patients were the victims of armed conflict, although no one was directly a party to any battle. This mechanism of injury is in strong opposition to data in the literature from developed countries, in which most missile injuries are the result of suicide or homicide or are even sports related. Moreover, all previous studies on the pediatric population have considered only injuries from gunshots, but authors of the current study have included injuries from other penetrating missiles as well. Results On cross tabulation analysis using the chi-square test, the factors shown to correlate with outcome included the Glasgow Coma Scale (GCS) score, pupillary abnormalities, patient age, hemodynamic status, and bihemispheric damage. On multinomial regression analysis, the two strongest predictors of death were GCS score and pupillary abnormalities. The GCS score and hemodynamic status were the strongest predictors of disability. Conclusions There was no difference in the prognostic factors for PMI between developing or more developed countries. Glasgow Coma Scale score, pupillary abnormalities, and hemodynamic status were the strongest predictors of outcome. In conflict zones in developing countries the victims were mostly innocent bystanders, whereas in the more developed countries homicides and suicides were the leading etiological factors.

scholarly journals Perbandingan Full Outline of Unresponsiveness Score dengan Glasgow Coma Scale dalam Menentukan Prognostik Pasien Sakit Kritis

Sari Pediatri ◽  
2016 ◽  
Vol 13 (3) ◽  
pp. 215
Author(s):  
Rismala Dewi ◽  
Irawan Mangunatmadja ◽  
Irene Yuniar
Keyword(s):  
Glasgow Coma Scale ◽  
Operating Characteristic ◽  
Coma Scale ◽  
Four Score

Latar belakang. Penilaian kesadaran penting dilakukan pada pasien anak dengan sakit kritis untuk memperkirakanprognosis. Modifikasi Glasgow Coma Scale (GCS) banyak digunakan untuk menilai kesadaran tetapi memilikiketerbatasan terutama pada pasien yang diintubasi. Terdapat skor alternatif baru yaitu Full Outline ofUnResponsiveness score (FOUR score) yang dapat digunakan untuk menilai kesadaran pasien terintubasi.Tujuan. Membandingkan FOUR score dengan GCS dalam menentukan prognosis pasien kritis, sehinggapemeriksaan FOUR score dapat digunakan sebagai alternatif pengganti GCS.Metode. Penelitian prospektif observasional pada anak usia di bawah 18 tahun yang dirawat di Unit PerawatanIntensif Anak RSCM dengan penurunan kesadaran. Waktu penelitian antara 1 Januari – 31 Maret 2011.Masing-masing subjek dinilai oleh 3 orang supervisor berbeda yang bekerja di Unit Perawatan Intensif Anak.Ketiga penilai diuji reliabilitas dalam menilai FOUR score dan GCS. Dibandingkan sensitivitas, spesifisitas, danreceiver operating characteristic (ROC) kedua sistem skor terhadap luaran berupa kematian di rumah sakit.Hasil. Reliabilitas tiap pasangan untuk FOUR score (FOUR 0,963; 0,890; 0,845) lebih baik daripadamodifikasi GCS (GCS 0,851; 0,740; 0,700). Terdapat hubungan yang bermakna antara besar skor danluaran kematian di rumah sakit dengan (pFOUR score = pGCS = 0,001). Nilai sensitivitas, spesifisitas, nilai prediksipositif dan negatif serta rasio kemungkinan positif masing-masing adalah 93%; 86%; 88%; 92%; 6,6. Areaunder curve (AUC) FOUR score 0,854 dan GCS 0,808Kesimpulan. Prediksi prognostik pada pasien yang dirawat di Unit Perawatan Intensif Anak dengan FOURscore lebih baik dibandingkan GCS.

scholarly journals A Useful New Coma Scale in Acute Stroke Patients: Four Score

2012 ◽  
Vol 40 (1) ◽  
pp. 131-136 ◽  
Author(s):  
Y. Kocak ◽  
S. Ozturk ◽  
F. Ege ◽  
A. H. Ekmekci
Keyword(s):  
Acute Stroke ◽  
Stroke Patients ◽  
Coma Scale ◽  
Four Score

FOUR score and Glasgow Coma Scale in predicting outcome of comatose patients: A pooled analysis

Neurology ◽  
2011 ◽  
Vol 77 (1) ◽  
pp. 84-85 ◽  
Author(s):  
E. F. M. Wijdicks ◽  
A. A. Rabinstein ◽  
W. R. Bamlet ◽  
J. N. Mandrekar
Keyword(s):  
Glasgow Coma Scale ◽  
Pooled Analysis ◽  
Coma Scale ◽  
Predicting Outcome ◽  
Four Score

Determination of Imminent Brain Death Using the Full Outline of Unresponsiveness Score and the Glasgow Coma Scale: A Prospective, Multicenter, Pilot Feasibility Study

2017 ◽  
Vol 35 (2) ◽  
pp. 203-207 ◽  
Author(s):  
Sergio Zappa ◽  
Nazzareno Fagoni ◽  
Michele Bertoni ◽  
Claudio Selleri ◽  
Monica Aida Venturini ◽  
...  
Keyword(s):  
Glasgow Coma Scale ◽  
Brain Death ◽  
Brain Stem ◽  
Deep Coma ◽  
Coma Scale ◽  
Four Score ◽  
Gcs Score ◽  
Brain Stem Reflexes ◽  
Pilot Feasibility Study

Purpose: To evaluate the accuracy of the imminent brain death (IBD) diagnosis in predicting brain death (BD) by daily assessment of the Full Outline of Unresponsiveness (FOUR) score and the Glasgow Coma Scale (GCS) with the assessment of brain stem reflexes. Materials and Methods: Prospective multicenter pilot study carried out in 5 adult Italian intensive care units (ICUs). Imminent brain death was established when the FOUR score was 0 (IBD-FOUR) or the GCS score was 3 and at least 3 among pupillary light, corneal, pharyngeal, carinal, oculovestibular, and trigeminal reflexes were absent (IBD-GCS). Results: A total of 219 neurologic evaluations were performed in 40 patients with deep coma at ICU admission (median GCS 3). Twenty-six had a diagnosis of IBD-FOUR, 27 of IBD-GCS, 14 were declared BD, and 9 were organ donors. The mean interval between IBD diagnosis and BD was 1.7 days (standard deviation [SD] 2.0 days) using IBD-FOUR and 2.0 days (SD 1.96 days) using IBD-GCS. Both FOUR and GCS had 100% sensitivity and low specificity (FOUR: 53.8%; GCS: 50.0%) in predicting BD. Conclusions: Daily IBD evaluation in the ICU is feasible using FOUR and GCS with the assessment of brain stem reflexes. Both scales had 100% sensitivity in predicting IBD, but FOUR may be preferable since it incorporates the pupillary, corneal, and cough reflexes and spontaneous breathing that are easily assessed in the ICU.

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