Role of FOUR and GCS in predicting outcome in emergency setting in patients presenting with trauma

Saima Mushtaq; Erma Hussain; Saddam Kannar; Asif Ali; Shehla Hina; Sara Abid

Abstract
Objective: To determine the role of GCS and FOUR scoring in predicting the mortality and outcome of trauma patients.
Methodology: This prospective study was conducted in Emergency department of Jinnah Post graduate Medical Center from July to December 2019. Consecutive non-probability sampling technique was utilized to include the patients in the study. Patient's age, Glasgow coma scale (GCS), full outline of unresponsiveness (FOUR) score and the outcome was noted in a self-designed questionnaire.
Results: Majority of patients with high GCS score (55.5%) were discharged in stable condition after medical management; 24.6% were admitted for surgical intervention and a small percentage were either referred to a sub-specialty or retained in emergency. In contrast, half of patients with low GCS score (50%) were admitted for a surgical intervention and 35.4% expired during their hospital stay. Amongst patients with a high FOUR score (between13-16), 52.29% were discharged in stable condition, 26.6% were admitted for surgical intervention and 1.4% expired. In patients with a low FOUR score (less than 5), 38% were admitted for surgical intervention and 57.1% expired.
Conclusion: The study showed that FOUR score and GCS score were equally good independent indicators of patient mortality and therefore, should be utilized to predict the outcome of trauma patients in emergency department.

Key words: FOUR Score, GCS Score, trauma, emergency.

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