Full outline of unresponsiveness versus Glasgow coma scale in predicting mortality in paediatric trauma patients


  • Tamer Fakhry Pediatric Surgery Unit, Faculty of Medicine, Menoufia University Hospitals, Egypt
  • Rania Salah Department of Emergency Medicine, Faculty of Medicine, Menoufia University Hospitals,Egypt
  • Ahmed Gaber Department of General Surgery, Faculty of Medicine, Menoufia University Hospitals,Egypt




Glasgow coma scale, Wounds and injuries, Trauma severity indices, Outcome assessment (health care)


Background: Many scoring models have been proposed for evaluating level of consciousness in trauma patients. The aim of this study is to compare Glasgow coma scale (GCS) and full outline of unresponsiveness (FOUR) score in predicting the morbidity and mortality of trauma paediatric patients.

Methods: In this diagnostic accuracy study trauma paediatric patients hospitalized in emergency room (ER) of Menoufia University hospital were evaluated. GCS and FOUR score of each patient were simultaneously calculated on admission as well as 6, 12 and 24 hours after that. The predictive values of the two scores and their area under the receiver operating characteristics (ROC) curve were compared.

Results: 100 patients were included in the present study (mean age 7.6±5.1; 77% male). Comparing the area under the ROC curve of GCS and FOUR score showed that these values were not different at any of the evaluated times: on admission (p=0.68), and 6 hours (p=0.13), 12 hours (p=0.18). However, The values of FOUR score was high accuracy than GCS score in predicting mortality in paediatric patients with ROC; 0.97, 0.89 respectively.

Conclusions: The results of our study showed that, GCS and FOUR score have the same value in predicting the mortality of trauma patients in first 24 hours. However, FOUR score has high accuracy than GCS score after 24 hours. Both tools had high predictive power in predicting the outcome at the time of discharge.


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Original Research Articles