Differences of the Glasgow Coma Scale and the Full Outline of Unresponsiveness Scores on Consciousness Level Examination

Fachmi Aditya

doi:10.37287/jppp.v2i4.215

Fachmi Aditya Universitas Lampung

DOI: https://doi.org/10.37287/jppp.v2i4.215

Keywords: full outline of unresponsiveness score, glasgow coma scale, consciousness level

Abstract

Consciousness is an integration between the sensory system, reasoning, imagination and emotions, and memory in receiving and processing information from the internal and external environment. Due to the large spectrum and causes of impaired consciousness, several methods are needed to check the level of consciousness, they are Glasgow Coma Scale and the Full Outline of Unresponsiveness Score. This article summarizes the differences in the use of the Glasgow Coma Scale and Full Outline of Unresponsiveness score methods in measuring the level of consciousness. The method used is literature searching from various national and international journals and using a digital library such as www.ncbi.nlm.nih.gov and Google Scholar with keyword Full Outline of Unresponsiveness (FOUR) score AND/OR Glasgow Coma Scale. The literature used totaled 14 articles which published in 2006 to 2019. The analytical method used is a systematic literature review method by systematically identifying, reviewing, and investigating research in terms of its title, approach, objectives, results, and discussion with a particular topic focus. The results of this literature study indicate that there are differences in the assessment components, inter-rater reliability, and differences in the predictive ability of mortality in the Glasgow Coma Scale method and the Full Outline of Unresponsiveness score so that the Full Outline of Unresponsiveness score can be an alternative or complement to Glasgow Coma Scale in measuring the level of consciousness.

References

Avner, J. R. (2006). Altered States of Consciousness. Pediatrics in Review, 27, 331–338. https://doi.org/10.1542/pir.27-9-331

Dewi, R., Mangunatmadja, I., & Yuniar, I. (2016). Perbandingan Full Outline of Unresponsiveness Score dengan Glasgow Coma Scale dalam Menentukan Prognostik Pasien Sakit Kritis. Sari Pediatri, 13(3), 215. https://doi.org/10.14238/sp13.3.2011.215-20

Fischer, M., Rüegg, S., Czaplinski, A., Strohmeier, M., Lehmann, A., Tschan, F., Hunziker, P. R., & Marsch, S. C. (2010). Inter-rater reliability of the Full Outline of UnResponsiveness score and the Glasgow Coma Scale in critically ill patients: a prospective observational study. Critical care (London, England), 14(2), R64. https://doi.org/10.1186/cc8963

Foo, C. C., Loan, J. J. M., & Brennan, P. M. (2019). The Relationship of the FOUR Score to Patient Outcome: A Systematic Review. Journal of Neurotrauma, 36(17), 2469–2483. https://doi.org/10.1089/neu.2018.6243

Ghelichkhani, P., Esmaeili, M., Hosseini, M., & Seylani, K. (2018). Glasgow Coma Scale and FOUR Score in Predicting the Mortality of Trauma Patients; a Diagnostic Accuracy Study. Emergency (Tehran, Iran), 6(1), e42. https://doi.org/10.22037/emergency.v6i1.21068

Iyer, V. N., Mandrekar, J. N., Danielson, R. D., Zubkov, A. Y., Elmer, J. L., & Wijdicks, E. F. (2009). Validity of the FOUR score coma scale in the medical intensive care unit. Mayo Clinic proceedings, 84(8), 694–701. https://doi.org/10.1016/S0025-6196(11)60519-3

Jalali, R., & Rezaei, M. (2014). A comparison of the glasgow coma scale score with full outline of unresponsiveness scale to predict patients’ traumatic brain injury outcomes in intensive care units. Critical Care Research and Practice, 2014. https://doi.org/10.1155/2014/289803

Jamal, A., Sankhyan, N., Jayashree, M., Singhi, S., & Singhi, P. (2017). Full Outline of Unresponsiveness score and the Glasgow Coma Scale in prediction of pediatric coma. World Journal of Emergency Medicine, 8(1), 55–60. https://doi.org/10.5847/wjem.j.1920

Khan, T., Stecker, M., & Stecker, M. (2015). Evaluating the patient with loss of consciousness. Surgical Neurology International, 6(7), S262-265. https://doi.org/10.4103/2152-7806.157615

Nik, A., Sheikh Andalibi, M. S., Ehsaei, M. R., Zarifian, A., Ghayour Karimiani, E., & Bahadoorkhan, G. (2018). The Efficacy of Glasgow Coma Scale (GCS) Score and Acute Physiology and Chronic Health Evaluation (APACHE) II for Predicting Hospital Mortality of ICU Patients with Acute Traumatic Brain Injury. Bulletin of Emergency and Trauma, 6(2), 141–145. https://doi.org/10.29252/beat-060208

Oktarina, Y., & Simajuntak, C. A. (2017). Perbandingan Glasgow Coma Scale Dengan Full Outline Of Unresponsiveness Score Dalam Mengukur Tingkat Kesadaran Pasien Terintubasi Endotracheal Tube Di Intensive Care Uni. Seminar Workshop Nasional Keperawatan “Implikasi Perawatan Paliatif Pada Bidang Kesehatan,1(1), 50–54.

Peng, J., Deng, Y., Chen, F., Zhang, X., Wang, X., Zhou, Y., … Qiu, B. (2015). Validation of the Chinese version of the FOUR score in the assessment of neurosurgical patients with different level of consciousness. BMC Neurology, 15(1), 1–8. https://doi.org/10.1186/s12883-015-0508-9

Ramazani, J., & Hosseini, M. (2019). Comparison of Full Outline of Unresponsiveness Score and Glasgow Coma Scale in Medical Intensive Care Unit. Annals of Cardiac Anaesthesia, 22(1), 143–148. https://doi.org/10.4103/aca.ACA

Storm, J. F., Boly, M., Casali, A. G., Massimini, M., Olcese, U., Pennartz, C. M. A., & Wilke, M. (2017). Consciousness regained: Disentangling mechanisms, brain systems, and behavioral responses. Journal of Neuroscience, 37(45), 10882–10893. https://doi.org/10.1523/JNEUROSCI.1838-17.2017

Tahir, A. M. (2019). Patofisiologi Kesadaran Menurun. UMI Medical Journal, 3(1), 80–88. https://doi.org/10.33096/umj.v3i1.37

Vithoulkas, G., & Muresanu, D. F. (2014). Conscience and consciousness: a definition. Journal of Medicine and Life, 7(1), 104–108.