scholarly journals NURSES’ AWARENESS AND PERCEPTION OF FOUR SCORE SCALE VERSUS GLASGOW COMA SCALE TOOL USED AMONG INTUBATED PATIENTS

2020 ◽  
Vol 12 (1) ◽  
pp. 63-72
Author(s):  
Mara Ross Abrina Yglesias ◽  
Emiliano Ian B. Suson II
Keyword(s):  
Glasgow Coma Scale ◽  
Coma Scale ◽  
Four Score

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.

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.

scholarly journals Penilaian Kesadaran pada Anak Sakit Kritis: Glasgow Coma Scale atau Full Outline of UnResponsiveness score?

Sari Pediatri ◽  
2016 ◽  
Vol 17 (5) ◽  
pp. 401
Author(s):  
Rismala Dewi
Keyword(s):  
Glasgow Coma Scale ◽  
Coma Scale ◽  
Four Score

Pemeriksaan neurologis tingkat kesadaran sangat penting untuk menilai secara komprehensif pasien anak sakit kritis, dan dapat memberikan informasi prognosis. Skala koma yang ideal seharusnya bersifat linear, reliabel, valid, dan mudah digunakan. Berbagai macam skala koma telah dikembangkan dan di validasi untuk mengevaluasi tingkat kesadaran secara cepat, menilai beratnya penyakit dan prognosis terhadap morbiditas dan mortalitas. Glasgow Coma Scale (GCS) merupakan alat pemeriksaan tingkat kesadaran yang paling sering digunakan dan dijadikan baku emas saat memvalidasi skala koma yang baru. GCS mempunyai keterbatasan karena pasien yang terintubasi tidak dapat dinilai komponen verbal sehingga memengaruhi hasil penilaian. FOUR Score dikembangkan untuk mengatasi berbagai keterbatasan yang dimiliki GCS. FOUR score lebih sederhana dan memberikan informasi yang lebih baik, terutama pada pasien-pasien yang terintubasi.

scholarly journals Efektifitas Antara Alat Ukur Coma Recovery Scale – Revised (Crs-R), Full Outline Unresponsiveness (Four) Score, dan Glasgow Coma Scale (Gcs) Dalam Menilai Tingkat Kesadaran Pasien di Unit Perawatan Intensif RSUD Raden Mattaher Jambi

2018 ◽  
Vol 2 (1) ◽  
pp. 68-74
Author(s):  
Dini Rudini
Keyword(s):  
Glasgow Coma Scale ◽  
Meta Analysis ◽  
Coma Scale ◽  
Consecutive Sampling ◽  
Four Score

Penilaian kesadaran penting dilakukan pada pasien yang mengalami penurunan kesadaran pada pasien di ICU, hal ini bertujuan untuk memperkirakan prognosis pada seorang pasien. Penentuan prognosis pasien di unit perawatan intensive merupakan suatu hal yang perlu diperhatikan. Jika terjadi kesalahan dalam menentukan prognosis maka dapat mengakibatkan kesalahan dalam pemberian terapi, khususnya yang berkaitan dengan pengobatan penyakit, berdasarkan studi meta - analysis terdapat  tiga alat ukur yang paling baik diantara alat-alat ukur lainnya yang digunakan untuk menilai tingkat kesadaran yaitu Glasgow Coma Scale (GCS), The Full Outline UnResponsiveness (FOUR) Score, Coma Recovery Scale - Revised (CRS-R). Ketiga alat ukur ini telah tervalidasi dan telah digunakan di beberapa rumah sakit oleh tenaga kesehatan. Dengan memperhatikan hal-hal tersebut, maka peneliti tertarik untuk melakukan penelitian di RSUD Raden Mattaher Jambi untuk melihat efektifitas antara alat ukur Coma Recovery Scale – Revised (CRS-R), Full Outline UnResponsiveness (FOUR) score, dan Glasgow Coma Scale (GCS)dalam menilai tingkat kesadaran pasien di unit perawatan intensif RSUD Raden Mattaher Jambi Tahun. Jenis penelitian yang digunakan oleh peneliti adalah penelitian studi perbandingan (comparative) dimana penelitian ini tidak memberikan perlakuan kepada subjek penelitian, penelitian ini hanya akan membandingkan 3 instrument pengkajian tingkat kesadaran. Rancangan penelitian yang digunakan adalah longitudinall, yaitu pengamatan tidak hanya dilakukan sekali. Pengambilan sampel pada penelitian ini dilakukan dengan consecutive sampling. Dalam penelitian ini menggunakan tiga instrument skala yaitu Coma Recovery Scale – Revised (CRS-R), Full Outline UnResponsiveness (FOUR) score, dan Glasgow Coma Scale (GCS). Analisis yang digunakan dalam penelitian ini adalah uji beda.Berdasarkan hasil penelitian dari 76 responden dengan penurunan kesadaran  Ada perbedaan validitas dan reliabilitas antara alat ukur Glasgow Coma Scale (GCS) dan Coma Recovery Scale – Revised (CRS-R) dalam menilai tingkat kesadaran pasien di Unit Perawatan Intensive RSUD Raden Mattaher Jambi tahun 2017 terdapat satu komponen pada alat ukur GCS yaitu respon verbal yang memiliki nilai kesepakatan antar penenliti yang moderate dan terdapat dua komponen dalam alat ukur CRS-R yaitu skala fungsi oromotor/verbal dan skala fungsi komunikasi yang memiliki nilai kesepakatan antar peneliti yang baik.

scholarly journals Assessing the effectiveness of the full outline of unresponsiveness scale and the Glasgow coma scale in patients of traumatic head injury

2021 ◽  
Vol 8 (12) ◽  
pp. 3583
Author(s):  
Fahad Ansari ◽  
Arvind Rai
Keyword(s):  
Head Injury ◽  
Glasgow Coma Scale ◽  
Youden Index ◽  
Traumatic Head Injury ◽  
Coma Scale ◽  
Medical College ◽  
Traumatic Head ◽  
Four Score ◽  
Gandhi Medical College ◽  
Gcs Score

Background: The Glasgow coma scale (GCS) is the most commonly used scale while the full outline of unresponsiveness (FOUR) score is a new validated coma scale in the evaluation of the level of consciousness in head injury patients. The aim of the study was to compare and assess the effectiveness of the FOUR score and the GCS in patients of traumatic head injury.Methods: This was a prospective observational study conducted in the department of surgery, Gandhi medical college, Bhopal during a 2 year period in which 100 patients of traumatic head injury were evaluated. The FOUR score and GCS score of these patients were assessed on admission and outcome followed for 2 weeks.Results: The mean age group of 100 patients was 25-45 years with 79% male and 21% female patients. The FOUR scale was found to have a marginally higher sensitivity of 65.6% while the GCS had a sensitivity of 64.2%. The FOUR scale however had a higher specificity of 71.5% compared to 66.4% of GCS. The Youden index showed that FOUR scale (46%) has a better prediction for death than GCS (35%). FOUR had a higher accuracy of 75% than GCS with an accuracy of 65%.Conclusions: Both FOUR score and GCS are valuable scales in assessment of traumatic head injury. The FOUR scale however is more accurate than the GCS in predicting outcome of head injury patients. 

scholarly journals Glasgow Coma Scale versus Full Outline of Unresponsiveness Scale in Predicting Discharge Outcomes of Traumatic Brain Injury

2019 ◽  
Vol 1 (4) ◽  
pp. 9
Author(s):  
Eman B. Kasem ◽  
Sahar Y. Mohammad ◽  
Dalia A. Amin
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Glasgow Coma Scale ◽  
Essential Element ◽  
University Hospital ◽  
Discharge Data ◽  
Coma Scale ◽  
Discharge Outcomes ◽  
Valid Predictor ◽  
Four Score

Context: Neurological assessment is an essential element of early warning scores used to recognize and early save the lives of critically ill patients.Aim: This study aimed to compare the full outline of Unresponsiveness Scale and the Glasgow Coma Scale in predicting discharge outcomes in patients with traumatic brain injuryMethod: A comparative research design conducted at Neurosurgery Intensive Care Unit in El Fayoum University Hospital. The Study recruited a purposive sample of 100 adult patients with TBI. They assessed using three tools (Patients Profile Data Form, Level of Consciousness Assessment," and Tool Discharge Data Assessment Record).Results: GCS is superior to FOUR score in prediction of length of stay and full recovery without any squeal while they are the same in the prediction of motor disability and sensory impairment (physical impairment). FOUR score is superior to GCS in the prediction of mortalityConclusion: the FOUR score provides more neurologic details than the GCS and is a valid predictor of outcome in patients with TBI; thus, it could be considered as a future prognostic model. It recommended for using FOUR score for predicting outcomes in patients with traumatic brain injuries as a valid predictor of discharge outcomes after traumatic brain injury.

scholarly journals Comparison of glasgow coma scale with full outline of unresponsiveness score in measuring consciousness level of endotracheal tube intubated patient in the intensive care unit

2018 ◽  
Vol 6 (6) ◽  
pp. 1882 ◽  
Author(s):  
Yosi Oktarina ◽  
Charles A. Simajuntak
Keyword(s):  
Glasgow Coma Scale ◽  
Endotracheal Tube ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
Respiratory Pattern ◽  
Observational Research ◽  
Measurement Tool ◽  
Coma Scale ◽  
Consciousness Level ◽  
Four Score

Background: Assessment of consciousness level is a basic ability that medical personnel, especially doctors and nurses shall master. It is due to assessment of consciousness as a basis of clinical decision making and determining the patient's prognosis. There are various types of scales to measure consciousness level of patient. One of the most famous and most widely applied is Glasgow Coma Scale (GCS). However, the use of GCS is less precise in measuring consciousness level of patients, especially in Endotracheal Tube Intubated patients (ETT). Another measure of consciousness assessment is FOUR Score. In contrast to GCS, the use of four score as a measurement tool for consciousness assessment is still not yet familiar especially in Indonesia. Four score has different component with GCS where the four score component has no assessment of verbal response but it has brainstem and respiratory pattern assessment components.Methods: This research was an observational research using prospective non-experimental approach. The sampling technique used was consecutive sampling with a sample size of 33 people. Observation of the sample was undertaken at the same time. The instruments used in this research were GCS and FOUR Score observation sheet. Data analysis was performed by measuring the sensitivity, specificity, positive predictive value, negative predictive value and ROC.Results: Four Score has sensitivity of 86.7 specificity of 83.3 predictive positive value of 81.3 and negative predictive value 88.2 and under curve area of 0.848. Meanwhile, GCS has sensitivity of 80.0, specificity of 77.8, predictive positive value of 75, and negative predictive value of 82.4 and under curve area of 0.819.Conclusions: Four scores have a better assessment in measuring the consciousness level of ETT intubated patients.

FOUR Score Challenges Glasgow Coma Scale

2005 ◽  
Vol 38 (24) ◽  
pp. 16
Author(s):  
MICHELE G. SULLIVAN
Keyword(s):  
Glasgow Coma Scale ◽  
Coma Scale ◽  
Four Score
Sign in / Sign up

Export Citation Format

Share Document