Full Outline of Un-Responsiveness Scale (FOUR) Versus Modified Glasgow Coma Scale (GCS) in Predicting Discharge Outcomes of Altered Consciousness Patients

Samah A Shalaby^1, , Nagwa A Reda¹ and Noha O Emam²

¹Critical Care and Emergency Nursing Department, Faculty of Nursing, Alexandria University, Alexandria, Egypt

²Critical Care Department, Assuit University Hospital, Assuit, Egypt

Cite this paper:
Samah A Shalaby, Nagwa A Reda and Noha O Emam. Full Outline of Un-Responsiveness Scale (FOUR) Versus Modified Glasgow Coma Scale (GCS) in Predicting Discharge Outcomes of Altered Consciousness Patients. American Journal of Nursing Research. 2019; 7(1):79-86. doi: 10.12691/ajnr-7-1-11

Abstract

Objective: Altered consciousness level is common in critically ill patients. Neurological assessment of these patients and their outcomes prediction are challenging for critical nurses. This study aimed to compare between Full Outline of Un-Responsiveness Scale and Modified Glasgow Coma Scale in predicting discharge outcomes in altered consciousness patients. Research Methodology: A descriptive design was followed in this study which was conducted at Trauma Intensive Care, Neurological Intensive Care and Neurosurgery Intensive Care units in Assuit University Hospital. Three tools were utilized to collect the data. Results: Patients' outcomes on discharge were; 3% regained consciousness and discharged to home; around one third regained consciousness and transferred to ward; some of them experienced co-morbidities; and nearly half of them were died after experiencing secondary brain injury. Almost one third of patients who were alive on discharge had physical disabilities and co-morbidities. Conclusions: The components of FOUR score and MGCS had different predictive abilities. FOUR score had higher accuracy prediction of in-hospital outcomes and the prognostic power than MGCS in the first three assessment days. Therefore, this study’s results would be supported by other studies that recruited a larger number of patients with different acuity levels within more hospitals.

Keywords:
altered level of consciousness unconscious patients coma scales FOUR score GCS

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