الفهرس | Only 14 pages are availabe for public view |
Abstract Disturbed consciousness level is common in critically ill patients. Neurological assessment, evaluation of a disturbed consciousness level patient and their outcomes prediction are usually challenging for critical care nurses. Scoring systems have been developed to obtain a fast and comprehensive assessment, to facilitate communication among examiners, to triage and monitor changes for therapeutic decisions, and to provide prognostic information about the patients’. The ideal scoring system for evaluating coma should be easy to administer, applicable to the greatest number of patients, able to accurately assess level of consciousness, identify rapidly deteriorating patients, and predict morbidity and mortality. The first known and widely accepted scale is the Glasgow Coma Scale (GCS). It has become the gold standard in clinical practice despite the GCS has been criticized for variable inter-rater agreement and inaccuracy in prognosis. Eye opening and verbal responses are influenced by local trauma, swelling, and tracheal intubation. The modified GCS had been adapted to be used in the assessment of altered consciousness for intubated patients in ICUs. They found that grimace score is more reliable than the verbal score. The Full Outline of Un-Responsiveness (FOURS) score was recently developed and validated and is an alternative to GCS and MGCS. The FOURS has been developed to assess the depth of coma in a more detailed manner. Furthermore, the FOURS is a robust predictor of in-hospital mortality, functional outcomes at hospital discharge, and overall survival in patients seen for neurologic complaints. The aim of this study is to compare between the Full Outline of Un-Responsiveness Scale and the Modified Glasgow Coma Scale in predicting discharge outcomes in disturbed consciousness patients. The study was conducted at the Trauma Intensive Care Unit (10 beds), Neurological Intensive Care Unit (12 beds) and Neurosurgery Intensive Care Unit (10 beds) in Assuit University Hospital. The sample of this study included 100 adult critically ill patients (based on the power analysis), newly admitted in the previously mentioned settings with disturbed consciousness available at the time of data collection. |