A useful new coma scale in acute stroke patients: FOUR score

Area of Science:

• Neurology
• Critical Care Medicine
• Neuroscience

Background:

• Assessing consciousness severity and predicting mortality are crucial in intensive care.
• Stroke patients require accurate prognostic tools for effective management.

Purpose of the Study:

• To evaluate the Full Outline of UnResponsiveness (FOUR) score's utility in intensive care unit (ICU) stroke patients.
• To correlate FOUR score with clinical outcomes and compare it with Glasgow Coma Scale (GCS) and APACHE II.

Main Methods:

• Prospective study of 100 acute stroke patients in a neurology ICU.
• FOUR scores were recorded on admission and days 1, 3, and 10.
• Comparison of FOUR scores between survivors and non-survivors; Receiver Operating Characteristic (ROC) curve analysis.

Main Results:

• Patients who died within 15 days had significantly lower FOUR scores on all recorded days compared to survivors.
• ROC analysis indicated significant prognostic value for both FOUR score and GCS.
• Area under the curve for FOUR score reached 0.981 on day 10, demonstrating high predictive accuracy.

Conclusions:

• The FOUR score is a valuable tool for assessing acute stroke patients in the ICU.
• FOUR score aids in estimating patient outcomes and prognosis.
• FOUR score provides a reliable method for evaluating stroke severity and predicting prognosis in critical care settings.