Full Outline of Unresponsiveness score and the Glasgow Coma Scale in prediction of pediatric coma
BACKGROUND: This study was done to compare the admission Full Outline of Unresponsiveness(FOUR) score and Glasgow Coma Scale(GCS) as predictors of outcome in children with impaired consciousness.METHODS: In this observational study, children(5–12 years) with impaired consciousness of <7 days...
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description | BACKGROUND: This study was done to compare the admission Full Outline of Unresponsiveness(FOUR) score and Glasgow Coma Scale(GCS) as predictors of outcome in children with impaired consciousness.METHODS: In this observational study, children(5–12 years) with impaired consciousness of <7 days were included. Children with traumatic brain injury, on sedatives or neuromuscular blockade; with pre-existing cerebral palsy, mental retardation, degenerative brain disease, vision/hearing impairment; and seizure within last 1 hour were excluded. Primary outcomes: comparison of area under curve(AUC) of receiver operating characteristic(ROC) curve for in-hospital mortality. Secondary outcomes: comparison of AUC of ROC curve for mortality and poor outcome on Pediatric Overall Performance Category Scale at 3 months.RESULTS: Of the 63 children, 20 died during hospital stay. AUC for in-hospital mortality for GCS was 0.83(CI 0.7 to 0.9) and FOUR score was 0.8(CI 0.7 to 0.9) (difference between areas –0.0250(95%CI 0.0192 to 0.0692), Z statistic 1.109, P=0.2674)AUC for mortality at 3 months for GCS was 0.78(CI 0.67 to 0.90) and FOUR score was 0.74(CI 0.62 to 0.87)(P=0.1102) and AUC for poor functional outcome for GCS was 0.82(CI 0.72 to 0.93) and FOUR score was 0.79(CI 0.68 to 0.9)(P=0.2377), which were also comparable. Inter-rater reliability for GCS was 0.96 and for FOUR score 0.98.CONCLUSION: FOUR score was as good as GCS in prediction of in-hospital and 3-month mortality and functional outcome at 3 months. FOUR score had a good inter-rater reliability. |
doi_str_mv | 10.5847/wjem.j.1920-8642.2017.01.010 |
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Children with traumatic brain injury, on sedatives or neuromuscular blockade; with pre-existing cerebral palsy, mental retardation, degenerative brain disease, vision/hearing impairment; and seizure within last 1 hour were excluded. Primary outcomes: comparison of area under curve(AUC) of receiver operating characteristic(ROC) curve for in-hospital mortality. Secondary outcomes: comparison of AUC of ROC curve for mortality and poor outcome on Pediatric Overall Performance Category Scale at 3 months.RESULTS: Of the 63 children, 20 died during hospital stay. AUC for in-hospital mortality for GCS was 0.83(CI 0.7 to 0.9) and FOUR score was 0.8(CI 0.7 to 0.9) (difference between areas –0.0250(95%CI 0.0192 to 0.0692), Z statistic 1.109, P=0.2674)AUC for mortality at 3 months for GCS was 0.78(CI 0.67 to 0.90) and FOUR score was 0.74(CI 0.62 to 0.87)(P=0.1102) and AUC for poor functional outcome for GCS was 0.82(CI 0.72 to 0.93) and FOUR score was 0.79(CI 0.68 to 0.9)(P=0.2377), which were also comparable. Inter-rater reliability for GCS was 0.96 and for FOUR score 0.98.CONCLUSION: FOUR score was as good as GCS in prediction of in-hospital and 3-month mortality and functional outcome at 3 months. FOUR score had a good inter-rater reliability.</description><identifier>ISSN: 1920-8642</identifier><identifier>DOI: 10.5847/wjem.j.1920-8642.2017.01.010</identifier><identifier>PMID: 28123622</identifier><language>eng</language><publisher>China: World Journal of Emergency Medicine (WJEM)</publisher><subject>Coma ; Consciousness ; Cornea ; Emergency medical care ; Head injuries ; Mortality ; Nurses ; Original ; Pain ; Patients ; Pediatrics ; Respiration ; Values ; Ventilators</subject><ispartof>World journal of emergency medicine, 2017, Vol.8 (1), p.55-60</ispartof><rights>Copyright World Journal of Emergency Medicine (WJEM) 2017</rights><rights>Copyright: © 2017 World Journal of Emergency Medicine 2017</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c434t-fe4cc70757cc4e3e13b9a0cfd2cbbe7bac2d5159422da6def08e81006ab7e29c3</citedby><cites>FETCH-LOGICAL-c434t-fe4cc70757cc4e3e13b9a0cfd2cbbe7bac2d5159422da6def08e81006ab7e29c3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Uhttp://image.cqvip.com/vip1000/qk/86073X/86073X.jpg</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC5263038/pdf/$$EPDF$$P50$$Gpubmedcentral$$H</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC5263038/$$EHTML$$P50$$Gpubmedcentral$$H</linktohtml><link.rule.ids>230,314,727,780,784,885,4024,27923,27924,27925,53791,53793</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/28123622$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Jamal, Atahar</creatorcontrib><creatorcontrib>Sankhyan, Naveen</creatorcontrib><creatorcontrib>Jayashree, Murlidharan</creatorcontrib><creatorcontrib>Singhi, Sunit</creatorcontrib><creatorcontrib>Singhi, Pratibha</creatorcontrib><title>Full Outline of Unresponsiveness score and the Glasgow Coma Scale in prediction of pediatric coma</title><title>World journal of emergency medicine</title><addtitle>World Journal of Emergency Medicine</addtitle><description>BACKGROUND: This study was done to compare the admission Full Outline of Unresponsiveness(FOUR) score and Glasgow Coma Scale(GCS) as predictors of outcome in children with impaired consciousness.METHODS: In this observational study, children(5–12 years) with impaired consciousness of &lt;7 days were included. Children with traumatic brain injury, on sedatives or neuromuscular blockade; with pre-existing cerebral palsy, mental retardation, degenerative brain disease, vision/hearing impairment; and seizure within last 1 hour were excluded. Primary outcomes: comparison of area under curve(AUC) of receiver operating characteristic(ROC) curve for in-hospital mortality. Secondary outcomes: comparison of AUC of ROC curve for mortality and poor outcome on Pediatric Overall Performance Category Scale at 3 months.RESULTS: Of the 63 children, 20 died during hospital stay. AUC for in-hospital mortality for GCS was 0.83(CI 0.7 to 0.9) and FOUR score was 0.8(CI 0.7 to 0.9) (difference between areas –0.0250(95%CI 0.0192 to 0.0692), Z statistic 1.109, P=0.2674)AUC for mortality at 3 months for GCS was 0.78(CI 0.67 to 0.90) and FOUR score was 0.74(CI 0.62 to 0.87)(P=0.1102) and AUC for poor functional outcome for GCS was 0.82(CI 0.72 to 0.93) and FOUR score was 0.79(CI 0.68 to 0.9)(P=0.2377), which were also comparable. Inter-rater reliability for GCS was 0.96 and for FOUR score 0.98.CONCLUSION: FOUR score was as good as GCS in prediction of in-hospital and 3-month mortality and functional outcome at 3 months. FOUR score had a good inter-rater reliability.</description><subject>Coma</subject><subject>Consciousness</subject><subject>Cornea</subject><subject>Emergency medical care</subject><subject>Head injuries</subject><subject>Mortality</subject><subject>Nurses</subject><subject>Original</subject><subject>Pain</subject><subject>Patients</subject><subject>Pediatrics</subject><subject>Respiration</subject><subject>Values</subject><subject>Ventilators</subject><issn>1920-8642</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2017</creationdate><recordtype>article</recordtype><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNpdkU1r3DAQhn1oaUKav1AE7aGXdUZftgylUJYmKQRyaHMWsjzelbGljWQn9N9XbrZLWzGSkOaZF43eovhAoZRK1FfPA07lUNKGwUZVgpUMaF0CzQGvivPT_VlxmdIAeShaqZq-Kc6YooxXjJ0X5noZR3K_zKPzSEJPHnzEdAg-uSf0mBJJNkQkxndk3iO5GU3ahWeyDZMh360ZkThPDhE7Z2cX_CpxyAczR2eJzdTb4nVvxoSXx_2ieLj--mN7u7m7v_m2_XK3sYKLedOjsLaGWtbWCuRIedsYsH3HbNti3RrLOkllIxjrTNVhDwoVBahMWyNrLL8oPr_oHpZ2ws6in6MZ9SG6ycSfOhin_814t9e78KQlqzhwlQU-HgVieFwwzXpyyeI4Go9hSZqq_GNKSLqi7_9Dh7BEn9vTjEJW41SKTH16oWwMKUXsT4-hoFcL9WqhHvRqlV6t0quFGmgOyOXv_m7oVPzHvAzwo_4--N2j87sTU4sGGqiUBKFEI-W6_p4N_wVT06yn</recordid><startdate>2017</startdate><enddate>2017</enddate><creator>Jamal, Atahar</creator><creator>Sankhyan, Naveen</creator><creator>Jayashree, Murlidharan</creator><creator>Singhi, Sunit</creator><creator>Singhi, Pratibha</creator><general>World Journal of Emergency Medicine (WJEM)</general><general>Second Affiliated Hospital of Zhejiang University School of Medicine</general><scope>2RA</scope><scope>92L</scope><scope>CQIGP</scope><scope>~WA</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>BVBZV</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>2017</creationdate><title>Full Outline of Unresponsiveness score and the Glasgow Coma Scale in prediction of pediatric coma</title><author>Jamal, Atahar ; Sankhyan, Naveen ; Jayashree, Murlidharan ; Singhi, Sunit ; Singhi, Pratibha</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c434t-fe4cc70757cc4e3e13b9a0cfd2cbbe7bac2d5159422da6def08e81006ab7e29c3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2017</creationdate><topic>Coma</topic><topic>Consciousness</topic><topic>Cornea</topic><topic>Emergency medical care</topic><topic>Head injuries</topic><topic>Mortality</topic><topic>Nurses</topic><topic>Original</topic><topic>Pain</topic><topic>Patients</topic><topic>Pediatrics</topic><topic>Respiration</topic><topic>Values</topic><topic>Ventilators</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Jamal, Atahar</creatorcontrib><creatorcontrib>Sankhyan, Naveen</creatorcontrib><creatorcontrib>Jayashree, Murlidharan</creatorcontrib><creatorcontrib>Singhi, Sunit</creatorcontrib><creatorcontrib>Singhi, Pratibha</creatorcontrib><collection>中文科技期刊数据库</collection><collection>中文科技期刊数据库-CALIS站点</collection><collection>中文科技期刊数据库-7.0平台</collection><collection>中文科技期刊数据库- 镜像站点</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>East & South Asia Database</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>World journal of emergency medicine</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Jamal, Atahar</au><au>Sankhyan, Naveen</au><au>Jayashree, Murlidharan</au><au>Singhi, Sunit</au><au>Singhi, Pratibha</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Full Outline of Unresponsiveness score and the Glasgow Coma Scale in prediction of pediatric coma</atitle><jtitle>World journal of emergency medicine</jtitle><addtitle>World Journal of Emergency Medicine</addtitle><date>2017</date><risdate>2017</risdate><volume>8</volume><issue>1</issue><spage>55</spage><epage>60</epage><pages>55-60</pages><issn>1920-8642</issn><abstract>BACKGROUND: This study was done to compare the admission Full Outline of Unresponsiveness(FOUR) score and Glasgow Coma Scale(GCS) as predictors of outcome in children with impaired consciousness.METHODS: In this observational study, children(5–12 years) with impaired consciousness of &lt;7 days were included. Children with traumatic brain injury, on sedatives or neuromuscular blockade; with pre-existing cerebral palsy, mental retardation, degenerative brain disease, vision/hearing impairment; and seizure within last 1 hour were excluded. Primary outcomes: comparison of area under curve(AUC) of receiver operating characteristic(ROC) curve for in-hospital mortality. Secondary outcomes: comparison of AUC of ROC curve for mortality and poor outcome on Pediatric Overall Performance Category Scale at 3 months.RESULTS: Of the 63 children, 20 died during hospital stay. AUC for in-hospital mortality for GCS was 0.83(CI 0.7 to 0.9) and FOUR score was 0.8(CI 0.7 to 0.9) (difference between areas –0.0250(95%CI 0.0192 to 0.0692), Z statistic 1.109, P=0.2674)AUC for mortality at 3 months for GCS was 0.78(CI 0.67 to 0.90) and FOUR score was 0.74(CI 0.62 to 0.87)(P=0.1102) and AUC for poor functional outcome for GCS was 0.82(CI 0.72 to 0.93) and FOUR score was 0.79(CI 0.68 to 0.9)(P=0.2377), which were also comparable. Inter-rater reliability for GCS was 0.96 and for FOUR score 0.98.CONCLUSION: FOUR score was as good as GCS in prediction of in-hospital and 3-month mortality and functional outcome at 3 months. FOUR score had a good inter-rater reliability.</abstract><cop>China</cop><pub>World Journal of Emergency Medicine (WJEM)</pub><pmid>28123622</pmid><doi>10.5847/wjem.j.1920-8642.2017.01.010</doi><tpages>6</tpages><oa>free_for_read</oa></addata></record> |
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subjects | Coma Consciousness Cornea Emergency medical care Head injuries Mortality Nurses Original Pain Patients Pediatrics Respiration Values Ventilators |
title | Full Outline of Unresponsiveness score and the Glasgow Coma Scale in prediction of pediatric coma |
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