Büyükcam Fatih, Kaya Ural, Karakılıç Muhamed Evvah, Cavuş Umut Yücel, Turan Sönmez Feruza, Odabaş Oner
Department of Emergency Medicine, Dışkapı Yıldırım Beyazıt Training and Research Hospital, Ankara, Turkey.
Ulus Travma Acil Cerrahi Derg. 2012 Nov;18(6):469-73. doi: 10.5505/tjtes.2012.23169.
Because of the limitations of the Glasgow Coma Scale (GCS), many scoring systems have emerged and been compared with GCS. Herein, we investigated whether the Full Outline of Unresponsiveness (FOUR) score is better than GCS in predicting morbidity and mortality in children with head trauma.
Patients 2-17 years of age who admitted to the emergency department with head trauma and presented with altered level of consciousness were included in this study. In-hospital mortality, hospitalization of more than three days, and Glasgow Outcome Score (GOS) at discharge and after three months were used as the primary outcome measures.
A total of 100 children were included in the study. The median age was 6 years, and 69% were male. The in-hospital mortality rate was 10%. The cut-off values for predicting in-hospital mortality were 9 for FOUR score and 7 for GCS. Area under the curve (AUC) values in predicting in-hospital mortality, poor GOS (score of 1-3) at discharge, and poor GOS after three months were similar for GCS and FOUR score.
FOUR score provides no significant advantage over GCS in predicting morbidity and mortality in children with head trauma.
由于格拉斯哥昏迷量表（GCS）存在局限性，许多评分系统应运而生并与GCS进行比较。在此，我们研究了全面无反应性（FOUR）评分在预测头部创伤儿童的发病率和死亡率方面是否优于GCS。
本研究纳入了2至17岁因头部创伤入住急诊科且意识水平改变的患者。以院内死亡率、住院超过三天、出院时及三个月后的格拉斯哥预后评分（GOS）作为主要结局指标。
本研究共纳入100名儿童。中位年龄为6岁，69%为男性。院内死亡率为10%。预测院内死亡率的截断值，FOUR评分为9分，GCS为7分。GCS和FOUR评分在预测院内死亡率、出院时不良GOS（评分1 - 3）及三个月后不良GOS方面的曲线下面积（AUC）值相似。
在预测头部创伤儿童的发病率和死亡率方面，FOUR评分相对于GCS没有显著优势。
