Abstract
Rapid assessment of cerebral dysfunction is crucial for the management of patients
in intensive care units. The Glasgow Coma Scale (GCS) evaluates eye, verbal, and motor
responses, but is insufficient to effectively evaluate patients on mechanical ventilation,
or who are unable to speak. The Full Outline of Unresponsiveness (FOUR) score includes
additional information such as brainstem reflexes and respiratory status to provide
a more complete clinical assessment. In this study, we aimed to compare the FOUR score
with GCS in the assessment of patients with coma. This prospective study included
patients between 1 month and under 18 years of age, who were hospitalized in the pediatric
intensive care unit due to risk of coma or ongoing impairment of consciousness between
May 2018 and June 2019. Information regarding FOUR scores, GCS values, patient demographics,
duration of hospitalization, requirement for mechanical ventilation, and patient comorbidities
were recorded and analyzed. Among the 80 patients included in the study, a statistically
significant correlation was found between (low) GCS and FOUR scores during admission,
and mortality and requirement for mechanical ventilation. Monitoring the level of
consciousness is important in pediatric intensive care units and may be predictive
of the course and disease outcome. Similar to the GCS, the FOUR score is a good indicator
for predicting mortality and requirement for mechanical ventilation.
Keywords
impairment of consciousness - glasgow coma scale - full outline of unresponsiveness
score - pediatric intensive care
