The FOUR Score Predicts Mortality, Endotracheal Intubation and ICU Length of Stay After Traumatic Brain Injury

Okasha, A; Fayed, Akram M.; Saleh, Ahmad Sabry

doi:10.1007/s12028-014-9995-6

Cited by 41 publications

(63 citation statements)

References 37 publications

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“…The FOUR score and the GCS score were not different in predicting unfavorable outcome (AUC 0.813 vs. 0.779, p=0.136) and endotracheal intubation (AUC 0.961 vs. 0.982, p=0.06). Both scores were good at predicting length of stay in an ICU [9]. In a recent multi-institutional study of unselected critically ill patients, the authors compared predictability of FOUR and GCS scores [17].…”

Section: Discussionmentioning

confidence: 99%

Prognostic value of FOUR and GCS scores in determining mortality in patients with traumatic brain injury

et al. 2015

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Section: Discussionmentioning

confidence: 99%

Prognostic value of FOUR and GCS scores in determining mortality in patients with traumatic brain injury

et al. 2015

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“…Okasha and coworkers found that the traditional GCS had similar predictive value regarding length of stay in ICU to the Full Outline of UnResponsiveness (FOUR) score. 11 It is therefore imperative to utilise any of the available scoring systems to predict likely length of stay in ICU for TBI patients as this may impact on resource allocation and outcome (see Figure 2). …”

Section: Limitationmentioning

confidence: 99%

Outcome of traumatic brain injury in the intensive care unit: a five-year review

Tobi

Azeez

Agbedia

2016

Southern African Journal of Anaesthesia and Analgesia

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Introduction: Traumatic brain injury (TBI) is a major challenge in the intensive care unit (ICU) with a high mortality. In a recent study, severe TBI accounted for 14.3% of all ICU admissions with a mortality of 54.0%. Methodology: This was a retrospective, case-control study of all cases of TBI admitted into the ICU during the study period. Data retrieved included socio-demographic parameters, causes of TBI, blood transfusion, length of stay and ICU outcome in terms of mortality. Result: One hundred and eighty-two (182) TBI patients were admitted into the ICU, with a mean age of 34 ± 18.92 years. The male:female ratio was 3:1, but females had a better outcome with a p-value of 0.026. Patients who stayed between 1 and 7 days were > 4 times more likely to die in the ICU compared with those who stayed for more than 7 days. In addition, TBI patients who had blood transfusion had a better outcome (p = 0.004). Also, TBI patients who received ventilatory support had higher mortality compared with those who did no, (p = 0.006). Conclusion:Patients with traumatic brain injury admitted to the intensive care unit have a high mortality. A review of the present line of management and strict compliance with guidelines of management may perhaps improve outcome.

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“…Also, age affects the relationship between GCS and anatomic TBI severity, with elderly patients having better GCS scores than younger despite similar brain damage [26]. As GCS does not directly evaluate brainstem function, the full outline of unresponsiveness score, which also includes brainstem reflexes, has been validated, although its superiority to predict patient outcome when compared with GCS remains controversial [27,28]. Finally, pupillary reflex assessment could be misleading in the clinical practice; as such, pupillary reactivity tested with an infrared pupillometer was more accurate than clinical pupillary evaluation in identifying postanoxic comatose patients with poor outcome and had comparable prognostic accuracy for outcome prediction than electroencephalography (EEG) and somatosensory-evoked potential [29 & ].…”

Section: Acute Brain Injurymentioning

confidence: 99%

Recommendations for the use of multimodal monitoring in the neurointensive care unit

Citerio

Oddo

Taccone

2015

Current Opinion in Critical Care

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MMM allows comprehensive exploration of the complex pathophysiology of acute brain damage and, depending on the different configuration of the pathological condition we are treating, the application of targeted individualized care. Unfortunately, we still lack robust evidence on how to better integrate MMM-derived information at the bedside to improve patient management. Advanced informatics is promising and may provide us a supportive tool to interpret physiologic events and guide pathophysiological-based therapeutic decisions.

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The FOUR Score Predicts Mortality, Endotracheal Intubation and ICU Length of Stay After Traumatic Brain Injury

Abstract: The FOUR score was superior to the GCS in predicting in-hospital mortality in TBI patients. There was no difference between both scores in predicting unfavorable outcome, endotracheal intubation, and ICU LOS.

Cited by 41 publications

References 37 publications

Prognostic value of FOUR and GCS scores in determining mortality in patients with traumatic brain injury

Prognostic value of FOUR and GCS scores in determining mortality in patients with traumatic brain injury

Outcome of traumatic brain injury in the intensive care unit: a five-year review

Recommendations for the use of multimodal monitoring in the neurointensive care unit

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