Alireza Baratloo1, Masumeh Shokravi2, Saeed Safari1, Awat Kamal Aziz3. 1. Department of Emergency Medicine, Shohadaye Tajrish Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran. 2. Department of Emergency Medicine, Shohadaye Tajrish Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran. drshokravi@yahoo.com. 3. Department of Anesthesia and Intensive Care Medicine, Oxford University Hospitals, Oxford, UK.
Abstract
INTRODUCTION: The Full Outline of Unresponsiveness (FOUR) score was developed to compensate for the limitations of Glasgow coma score (GCS) in recent years. This study aimed to assess the predictive value of GCS and FOUR score on the outcome of multiple trauma patients admitted to the emergency department. PATIENTS AND METHODS: The present prospective cross-sectional study was conducted on multiple trauma patients admitted to the emergency department. GCS and FOUR scores were evaluated at the time of admission and at the sixth and twelfth hours after admission. Then the receiver operating characteristic (ROC) curve, sensitivity, specificity, as well as positive and negative predictive value of GCS and FOUR score were evaluated to predict patients' outcome. Patients' outcome was divided into discharge with and without a medical injury (motor deficit, coma or death). RESULTS: Finally, 89 patients were studied. Sensitivity and specificity of GCS in predicting adverse outcome (motor deficit, coma or death) were 84.2% and 88.6% at the time of admission, 89.5% and 95.4% at the sixth hour and 89.5% and 91.5% at the twelfth hour, respectively. These values for the FOUR score were 86.9% and 88.4% at the time of admission, 89.5% and 100% at the sixth hour and 89.5% and 94.4% at the twelfth hour, respectively. CONCLUSION: Findings of this study indicate that the predictive value of FOUR score and GCS on the outcome of multiple trauma patients admitted to the emergency department is similar.
INTRODUCTION: The Full Outline of Unresponsiveness (FOUR) score was developed to compensate for the limitations of Glasgow coma score (GCS) in recent years. This study aimed to assess the predictive value of GCS and FOUR score on the outcome of multiple traumapatients admitted to the emergency department. PATIENTS AND METHODS: The present prospective cross-sectional study was conducted on multiple traumapatients admitted to the emergency department. GCS and FOUR scores were evaluated at the time of admission and at the sixth and twelfth hours after admission. Then the receiver operating characteristic (ROC) curve, sensitivity, specificity, as well as positive and negative predictive value of GCS and FOUR score were evaluated to predict patients' outcome. Patients' outcome was divided into discharge with and without a medical injury (motor deficit, coma or death). RESULTS: Finally, 89 patients were studied. Sensitivity and specificity of GCS in predicting adverse outcome (motor deficit, coma or death) were 84.2% and 88.6% at the time of admission, 89.5% and 95.4% at the sixth hour and 89.5% and 91.5% at the twelfth hour, respectively. These values for the FOUR score were 86.9% and 88.4% at the time of admission, 89.5% and 100% at the sixth hour and 89.5% and 94.4% at the twelfth hour, respectively. CONCLUSION: Findings of this study indicate that the predictive value of FOUR score and GCS on the outcome of multiple traumapatients admitted to the emergency department is similar.