Temiz Nail Caglar, Kose Gulsah, Tehli Ozkan, Acikel Cengizhan, Hatipoglu Sevgi
University of Health Sciences, Gulhane Training and Research Hospital, Department of Neurosurgery, Ankara, Turkey.
Turk Neurosurg. 2018;28(2):248-250. doi: 10.5137/1019-5149.JTN.19504-16.0.
To evaluate the effectiveness and the use of Glasgow Coma Score (GCS) and Full Outline of Unresponsiveness (FOUR) score by nurses in the follow-up and evaluation of patients admitted to the neurosurgical intensive care unit for cranial surgery or head trauma.
The study was performed at a neurosurgical intensive care unit. Sample size was determined as 47 patients (a= 0.05, power= 0.95). The correlation coefficient less than 0.5 was accepted as weak. In the first 24 hours, Karnofsky Performance Scale was applied and the Acute Physiology and Chronic Health Evaluation II (APACHE II) Score calculated for patients who were admitted to the intensive care unit for cranial surgery or head trauma. Also FOUR and GCS were applied by two different nurses twice a day. Intraclass Correlation Coefficient, Pearson Correlation and Cronbach?s Alpha Security Index analyses were used to evaluate the data.
Concordance was above 0.810 and correlation was above 0.837 between GCS and FOUR score evaluation results of nurses. Correlation of two different evaluation at every shift for GCS was 0.887, and for FOUR was 0.827 and above. Karnofsky Performance Scale correlation with FOUR and GCS scores of patients at admission and discharge from the intensive care unit was 0.709 and above. The correlation between APACHE II and FOUR was 0.851; between APACHE II and GCS 0.853. There was no difference between the evaluations of two scores and two nurses statistically.
Concordance between nurses was found high both for GCS and FOUR. The FOUR score is as effective as GCS on the follow-up of patients who are managed in the neurosurgical intensive care units.
评估护士在对因颅脑手术或头部创伤入住神经外科重症监护病房的患者进行随访和评估时，格拉斯哥昏迷评分（GCS）和全面无反应性大纲（FOUR）评分的有效性及应用情况。
本研究在一个神经外科重症监护病房进行。样本量确定为47例患者（α = 0.05，检验效能 = 0.95）。相关系数小于0.5被视为弱相关。在最初的24小时内，应用卡氏功能状态量表，并为因颅脑手术或头部创伤入住重症监护病房的患者计算急性生理与慢性健康状况评分II（APACHE II）。同时，由两名不同的护士每天两次应用FOUR和GCS评分。采用组内相关系数、Pearson相关系数和Cronbach's Alpha信度指数分析来评估数据。
护士对GCS和FOUR评分的评估结果之间的一致性高于0.810，相关性高于0.837。GCS在每个班次的两次不同评估之间的相关性为0.887，FOUR为0.827及以上。在重症监护病房入院和出院时，卡氏功能状态量表与患者的FOUR和GCS评分之间的相关性为0.709及以上。APACHE II与FOUR之间的相关性为0.851；APACHE II与GCS之间为0.853。两种评分和两名护士的评估在统计学上没有差异。
发现护士对GCS和FOUR的评估一致性都很高。在神经外科重症监护病房对患者进行随访时，FOUR评分与GCS评分一样有效。
