Validity and Predictive Value of the FOUR Score Coma Scale in Stroke Patients: a Systematic Review

The FOUR Score Coma Scale in stroke patients

  • Alireza Ala Emergency Medicine Research Team, Tabriz University of Medical Sciences, Tabriz, Iran
  • Samad Shams Vahdati Emergency Medicine Research Team, Tabriz University of Medical Sciences, Tabriz, Iran
  • Nafiseh Vahed Research Center for Evidence Based Medicine, Iranian EBM Centre: A Joanna Briggs Institute Affiliated Center, Tabriz University of Medical Sciences, Tabriz, Iran
  • Sahar Mohammadi Department of Emergency Medicine, Zanjan University of Medical Sciences, Zanjan, Iran
  • Hoorolnesa Ameli Clinical Research Development Center, Shahid Beheshti Hospital, Qom University of Medical Sciences, Qom, Iran.

Abstract

Objectives: Stroke is known as the second common cause of mortality and the third most common cause of morbidity all over the world .The aim of this study was to evaluate and systematic review the validity and predictive value of the Full Outline of UnResponsiveness (FOUR) Score Coma Scale in stroke patients.

Materials and Methods: In this systematic review, literature from Medline (PubMed, Ovid), The Cochrane Library, Scopus, Embase, ProQuest, published between 1988 and 2020 were included. The search strategy included a combination of free and MeSH terms such as "FOUR Score", "Full Outline of UnResponsiveness", Stroke, and "cerebrovascular accident".

Results: The total number of patients included was 5515, with sample sizes ranging from 53 to 1645 patients. FOUR score was a reliable scale for estimating prognosis in stroke patients. The predictive value of FOUR score in the outcomes of traumatic patients was better than the Glasgow coma score. However in some studies, FOUR Score was not superior to the Glasgow coma score.

Conclusion: In conclusion, FOUR score coma scale with an appropriate validity and predictive value can be proposed as a valid substitute for Glasgow coma score.

Keywords: Stroke; FOUR Score; Validity; Predictive Value.

Published
2020-10-17
Section
Review Article