Prediction of Mortality using Full Outline of Unresponsiveness Versus Glasgow Coma Scale Scores in Traumatic Brain Injury Patients: An Observational Comparative Study

Abstract

Introduction: Traumatic Brain Injury (TBI) is an alteration in the brain's normal function that an external force can cause. The most reliable outcome prediction is essential to portray the burden of TBI. Hence, the present study compared two scores of the Full Outline of UnResponsiveness (FOUR) scale and GCS in predicting mortality in patients with traumatic brain injuries. Methodology: A comparative observational study was conducted with 60 patients with traumatic brain injury who matched with inclusion criteria at the Intensive care unit of Saveetha Medical College and Hospital. The mortality rate was predicted by measuring the responses mentioned in the Full Outline of Unresponsiveness (FOUR) scale and Glasgow Coma Scale daily from the day of admission to till seven days. Results Both scale was statistically effective in predicting mortality rate. The predicted mortality rate on all seven days using the FOUR score was statistically (p<0.001) better than the GCS score among patients with traumatic brain injury. The baseline variable of age in years and length of admission to ICU had a statistically significant association with the Day 7 FOUR score and GCS score of mortality prediction at p<0.05 level. Conclusion: The Findings of the present study concluded that the FOUR score is comparable to the GCS score and more effective in predicting hospital mortality among critically ill patients in the intensive care unit.