Comparison between Full Outline Unresponsiveness (FOUR) and Glasgow coma Score for predicting survival in hemorrhagic stroke patients
Keywords:
FOUR score, Glasgow coma score, hemorrhagic strokeAbstract
Introduction: Hemorrhagic stroke is common disease That was found in the emergency department. The prognosis is poor and Glasgow coma score (GCS) has limited accuracy for predicting prognosis. Full Outline UnResponsiveness (FOUR) score is better than GCS for predicting prognosis and neurological outcome in ischemic stroke and post cardiac arrest patients. So we had concept for using FOUR score for predicting prognosis in these patients.
Objectives: to study prognostic accuracy of 28-day survival in hemorrhagic stroke patients who were predicted by FOUR and GCS.
Method: The prospective cohort study. We analyzed the data by STATA version 15.0 from 145 hemorrhagic stroke patients who visited The Emergency department at Chonburi hospital between 1st October- 31st December. For compare survival accuracy of FOUR score and GCS, we calculated the sensitivity, specificity, PPV, NPV and AUROC curves. Cox’s regression was analyzed mortality at appropriated cut off point.
Results: 145 patients were included in the study. Mean FOUR and GCS score were 8.6 ± 5.9 and 8.6± 4.4 respectively. Overall survival rate was 46.9% AUROC of FOUR score was 0.934 and GCS was 0.885 respectively. The hemorrhagic stroke patient who had FOUR score greater than or equal to 13 point, had greater tendency for 28 day than the other group. (Hazard ratio 39.21)
Conclusion: FOUR score have better prognostic accuracy than Glasgow coma score and for predicting survival in hemorrhagic stroke patients.
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