Serial FOUR Score and Glasgow Coma Score in Critically Ill Medical Patients: Relation to Outcome (P02.212)

Abstract

Objective: To study the relation of serial FOUR Score, Glascow Coma Score (GCS) and their component scores to outcome at 3 month among non-surgical patients with altered mental status. Background Full Outline of UnResponsiveness or FOUR Score (FS) is a recently described scoring system for evaluation of altered sensorium. Recently, we demonstrated its inter-rater reliability to be comparable to GCS among non-surgical patients. Few studies have evaluated utility of serial FS, GCS or their component scores in outcome prediction. Design/Methods: Adult patients with altered mental status due to non-traumatic, non-surgical causes were rated by Neurology consultants on FS and GCS on the first three days of hospital admission. These scores, as well as clinical and biochemical parameters monitored for defining organ dysfunctions were evaluated for their relation to outcomes at 3 months using univariate, multivariate and ROC curve analyses. Results: Of the 100 patients (M:F::58:42, Age: 62+17 yrs), 60 had neurologic conditions, 26-Metabolic encephalopathy; 9-Infections; 7-others. 39 patients died at 3 months. Mortality was significantly related to systolic BP (p=0.013); GCS and component scores on 3 days (p Conclusions: Outcome predictability using FOUR score at 3 months was relatively better than GCS for patients with medical conditions causing altered sensorium. Motor components of both FS and GCS performed as well as total scores. Serial evaluation of coma scores may not improve their predictive value as compared to the evaluation on at admission. Supported by: Dean9s Fund, Sultan Qaboos University, Muscat, Oman. Disclosure: Dr. Gujjar has nothing to disclose. Dr. Jacob has nothing to disclose. Dr. Nandhagopal has nothing to disclose. Dr. Ganguly has nothing to disclose. Dr. Obaidy has nothing to disclose. Dr. Al-Asmi has nothing to disclose.