The FOUR Score Predicts Outcome in Patients after Cardiac Arrest

Fugate, Jennifer E.; Rabinstein, Alejandro A.; Claassen, Daniel O.; White, Roger D.; Wijdicks, Eelco F. M.

doi:10.1007/s12028-010-9407-5

Cited by 56 publications

(44 citation statements)

References 20 publications

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“…In addition, no patient with a FOUR score of 0 or 1 survived, while 20% of patients with a GCS total score of 3 were alive at 3 month follow-up. Although this finding does not reach statistical significance, it corroborates previous studies [30,35]. The GLS was shown to herald superior outcome prediction as compared to the GCS [36,37], but the GLS was here not shown to be superior to the prognostic capacity of the FOUR.…”

Section: Discussionsupporting

confidence: 82%

Comparison of the Full Outline of UnResponsiveness and Glasgow Liege Scale/Glasgow Coma Scale in an Intensive Care Unit Population

et al. 2011

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Background The Full Outline of UnResponsiveness (FOUR) has been proposed as an alternative for the Glasgow Coma Scale (GCS)/Glasgow Liège Scale (GLS) in the evaluation of consciousness in severely brain-damaged patients. We compared the FOUR and GLS/GCS in intensive care unit patients who were admitted in a comatose state. Methods FOUR and GLS evaluations were performed in randomized order in 176 acutely (<1 month) braindamaged patients. GLS scores were transformed in GCS scores by removing the GLS brainstem component. Interrater agreement was assessed in 20% of the studied population (N = 35). A logistic regression analysis adjusted for age, and etiology was performed to assess the link between the studied scores and the outcome 3 months after injury (N = 136). Results GLS/GCS verbal component was scored 1 in 146 patients, among these 131 were intubated. We found that the inter-rater reliability was good for the FOUR score, the GLS/GCS. FOUR, GLS/GCS total scores predicted functional outcome with and without adjustment for age and etiology. 71 patients were considered as being in a vegetative/unresponsive state based on the GLS/GCS. The FOUR score identified 8 of these 71 patients as being minimally conscious given that these patients showed visual pursuit. Conclusions The FOUR score is a valid tool with good inter-rater reliability that is comparable to the GLS/GCS in predicting outcome. It offers the advantage to be performable in intubated patients and to identify non-verbal signs of consciousness by assessing visual pursuit, and hence minimal signs of consciousness (11% in this study), not assessed by GLS/GCS scales.

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Section: Discussionsupporting

confidence: 82%

Comparison of the Full Outline of UnResponsiveness and Glasgow Liege Scale/Glasgow Coma Scale in an Intensive Care Unit Population

et al. 2011

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“…According to brain stem reflexes assessment in the FOUR scale, the primary minimum score predicts the amount of brain death better than GCS score (7,19). Other studies have also reported that the two GCS and FOUR scores have a good correlation with each other to predict mortality and recovery rates, not being in agreement with the results of our study (15).…”

Section: Discussioncontrasting

confidence: 50%

Ability of Glasgow Coma Scale and Full Outline of Unresponsiveness Score in Measuring Level of Consciousness and Outcome in Patients Receiving Sedation Under Mechanical Ventilation

Keykha¹,

Askari²,

Navidian³

et al. 2017

Crit Care Nurs J

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“…Recently, a more comprehensive score has been developed, known as the FOUR score -Full Outline of UnResponsiveness. Fugate et al utilized this score to determine if it was able to predict outcome in patients after cardiac arrest (24). They assessed both TH and non-TH patients.…”

Section: Neuro Exammentioning

confidence: 99%

Prognostication in Post Cardiac Arrest Patients Treated with Therapeutic Hypothermia

Palagiri¹,

Sadaka²,

Lakshmanan³

2013

Therapeutic Hypothermia in Brain Injury

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The FOUR Score Predicts Outcome in Patients after Cardiac Arrest

Abstract: The FOUR score, a simple clinical tool, is an accurate predictor of outcome in patients surviving cardiac arrest.

Cited by 56 publications

References 20 publications

Comparison of the Full Outline of UnResponsiveness and Glasgow Liege Scale/Glasgow Coma Scale in an Intensive Care Unit Population

Comparison of the Full Outline of UnResponsiveness and Glasgow Liege Scale/Glasgow Coma Scale in an Intensive Care Unit Population

Ability of Glasgow Coma Scale and Full Outline of Unresponsiveness Score in Measuring Level of Consciousness and Outcome in Patients Receiving Sedation Under Mechanical Ventilation

Prognostication in Post Cardiac Arrest Patients Treated with Therapeutic Hypothermia

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