A multicenter prospective study of interobserver agreement using the Full Outline of Unresponsiveness score coma scale in the intensive care unit

Abstract

The Full Outline of Unresponsiveness score showed excellent inter-rater agreement overall and at each of the five hospitals. This demonstrates that the Full Outline of Unresponsiveness score can be utilized reliably in critically ill patients.

A comparison between the effectiveness of full outline of unresponsiveness and glasgow coma score at neurosurgical intensive care unit patients

“…Also correlation for both scales was quite strong. Other studies have stated that coefficient of concordance and correlation between practitioners were high as in our work (5,7,9,10,(12)(13)(14). This conclusion is thought to be helpful for decreasing mistakes when evaluating intensive care unit patients and a more accurate evaluation can be made.…”

“…Grading the level of consciousness makes communication between medical staff more powerful and effective (10,15). GCS and FOUR score are the most common used scales for this purpose (1,5,14).…”

“…Therefore using the FOUR score ensures that brainstem reflexes, respiration pattern and verbal response that are supplementary data for patient evaluation, absent in GCS, can be used (3,4,9). The FOUR score has advantages and still investigated by different countries and clinics (10). In some studies, there was no sample calculation for comparing GCS and FOUR, no surveys for GCS and FOUR at the same time, studies reported just for the first 24 hours and only traumatic brain injury patients or intubated patients had been included (1,4,9,10,14).…”

“…However, there is no objective value such as body temperature or blood pressure to evaluate intensive care unit comatose patients, and therefore different scales are used (10). One of these scales is Glasgow Coma Score (GCS), which is known worldwide and commonly used to predict the level of, consciousness, mortality and morbidity (4,9,10,13).…”

“…The FOUR score has advantages and still investigated by different countries and clinics (10). In some studies, there was no sample calculation for comparing GCS and FOUR, no surveys for GCS and FOUR at the same time, studies reported just for the first 24 hours and only traumatic brain injury patients or intubated patients had been included (1,4,9,10,14). There is no survey that includes all cases such as brain tumor patients or head trauma patients and lasts longer than one day.…”