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Full Outline of UnResponsiveness score and Glasgow Coma Scale in medical patients with altered sensorium: Interrater reliability and relation to outcome
Journal of Critical Care, 08/17/2012
Gujjar AR et al. – Interrater reliability and outcome predictability for FOUR score (FS) were comparable with those for Glasgow Coma Scale (GCS). This study supports the use of FS for evaluation of altered mental status in the medical wards.
Methods- Adult patients with altered mental status due to medical causes were rated by neurology consultants and internal medicine residents on FS and GCS.
- Interobserver reliability for GCS and FS was assessed using κ score.
- Relation with outcomes was explored using univariate and multivariate analyses.
- Of the 100 patients (age, 62±17years), 60 had neurologic conditions; 26, metabolic encephalopathy; 9, infections; and 7, others.
- Thirty–nine patients died at 3months.
- κ Scores ranged from 0.71 to 0.85 for GCS and from 0.71 to 0.95 for FS.
- On multivariate analysis, GCS was predictive of outcome at 3months; FS was predictive of mortality.
- Area under the receiver operating characteristic curves suggested equivalent performance of both scoring systems.
