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Glasgow Coma Scale and FOUR Score in Predicting the Mortality of Trauma Patients; a Diagnostic Accuracy Study

Parisa Ghelichkhani, Maryam Esmaeili, Mostafa Hosseini, Khatereh Seylani




Introduction: Many scoring models have been proposed for evaluating level of consciousness in trauma patients. The aim of this study is to compare Glasgow coma scale (GCS) and Full Outline of UnResponsiveness (FOUR) score in predicting the mortality of trauma patients.

Methods: In this diagnostic accuracy study trauma patients hospitalized in intensive care unit (ICU) of 2 educational hospitals were evaluated. GCS and FOUR score of each patient were simultaneously calculated on admission as well as 6, 12 and 24 hours after that. The predictive values of the two scores and their area under the receiver operating characteristics (ROC) curve were compared.

Results: 90 patients were included in the present study (mean age 39.4±17.3; 74.4% male). Comparing the area under the ROC curve of GCS and FOUR score showed that these values were not different at any of the evaluated times: on admission (p=0.68), and 6 hours (p=0.13), 12 hours (p=0.18), and 24 hours (p=0.20) after that.

Conclusion: The results of our study showed that, GCS and FOUR score have the same value in predicting the mortality of trauma patients. Both tools had high predictive power in predicting the outcome at the time of discharge.


Glasgow Coma Scale; Wounds and Injuries; Trauma Severity Indices; Outcome Assessment (Health Care); Critical Care; Intensive Care Units


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DOI: https://doi.org/10.22037/emergency.v6i1.21068


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