Weiss N, Mutlu G, Essardy F, Nacabal C, Sauves C, Bally C, Houbert M, Lecorre C, Germack V, Demeret S, Pierrot-Deseilligny C, Bolgert F
hôpital de la Pitié-Salpêtrière, Paris, France.
Rev Neurol (Paris). 2009 Oct;165(10):796-802. doi: 10.1016/j.neurol.2009.01.045. Epub 2009 Mar 17.
Comatose state is a major cause for admission to the intensive care unit. The most commonly used assessment score is the Glasgow coma scale (GCS). Although widely accepted, this score has several limitations. Recently, the full outline of unresponsiveness score (FOUR) has been validated and tested as reliable as the GCS.
We translated this score in French and tested its reliability in a neurological critical care unit. This study included eight critical care patients and eight intensive care patients. The patients were successively evaluated by two neurologists, four experienced nurses and five inexperienced nurses; a total of 176 evaluations were performed. The weighted kappa (kappa(W)) was used to determine the reliability of the evaluation for both the FOUR score and the GCS.
The mean age of the patients was 62 years. The interobserver reliability of the French version of the FOUR score was high (kappa(W)=0.86; IC 95%: 0.83-0.89) comparable to that of the GCS (kappa(W)=0.85; IC 95%: 0.82-0.88).
The French version of the FOUR score has an excellent interobserver reliability. This score is easy to perform and well accepted, only requiring simple and short training.
昏迷状态是入住重症监护病房的主要原因。最常用的评估分数是格拉斯哥昏迷量表（GCS）。尽管该分数被广泛接受，但它有几个局限性。最近，全面无反应性评分（FOUR）已得到验证，并被证明与GCS一样可靠。
我们将该评分翻译成法语，并在神经重症监护病房测试其可靠性。本研究纳入了8例重症监护患者和8例普通监护患者。由两位神经科医生、四位经验丰富的护士和五位经验不足的护士对患者进行连续评估；共进行了176次评估。加权kappa（kappa（W））用于确定FOUR评分和GCS评估的可靠性。
患者的平均年龄为62岁。法语版FOUR评分的观察者间可靠性较高（kappa（W）=0.86；95%置信区间：0.83-0.89），与GCS相当（kappa（W）=0.85；95%置信区间：0.82-0.88）。
法语版FOUR评分具有出色的观察者间可靠性。该评分易于实施且接受度高，只需要简单且简短的培训。
