Comparison between the Ability of Glasgow Coma Scale and Full Outline of Unresponsiveness Score to Predict the Mortality and Discharge Rate of Pediatric Intensive Care Unit Patients

Ali  Khajeh; Afshin  Fayyazi; Ghasem  Miri-Aliabad; Hasan  Askari; Noormohammad  Noori; Behrouz  Khajeh

Comparison between the Ability of Glasgow Coma Scale and Full Outline of Unresponsiveness Score to Predict the Mortality and Discharge Rate of Pediatric Intensive Care Unit Patients

Ali Khajeh ¹ , Afshin Fayyazi ² , Ghasem Miri-Aliabad ³ , Hasan Askari ^{4
, *} , Noormohammad Noori ⁵ and Behrouz Khajeh ⁶

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Article information

Iranian Journal of Pediatrics: October 31, 2014, 24 (5); 603-608
Published Online: September 12, 2014
Article Type: Research Article
Received: October 25, 2014
Accepted: August 09, 2014

To Cite: Khajeh A , Fayyazi A , Miri-Aliabad G , Askari H , Noori N , et al. Comparison between the Ability of Glasgow Coma Scale and Full Outline of Unresponsiveness Score to Predict the Mortality and Discharge Rate of Pediatric Intensive Care Unit Patients , Iran J Pediatr. 2014 ;24(5):603-608.

Abstract

Objective: Prediction of survival and mortality rates in costly environments such as the intensive care unit (ICU) is of great importance for the assessment of new treatments, resource consumption control, and improvement of quality control. This study aimed to determine the ability to predict mortality and discharge rate of patients using the FOUR score in the pediatric ICU (PICU) of Ali Ibn Abitalib Hospital, Zahedan and compare the results with those of Glasgow Coma Scale (GCS). Methods: This prospective study was conducted on 200 patients admitted to the PICU. Convenience purposive sampling was used. Research data was collected using the Full Outline of Unresponsiveness (FOUR) score and GCS using questionnaires. Obtained data was analyzed with SPSS 16 using descriptive statistics and correlation analyses. Findings: Of the 200 children admitted to the PICU, 71.5% and 28.5% were discharged and died, respectively. The inter-rater reliability for the FOUR score was good to excellent (weighted κ: eye, 0.72; respiration, 0.82; brainstem, 0.74; motor, 0.78), In terms of mortality and discharge prediction, logistic regression analyses (FOUR score = OR: 0.13; 95% CI: 0.06–0.29; P<0.001; GCS=OR: 2.49; 95% CI: 1.44–4.32; P<0.001) showed that the FOUR score is a good predictor for in-hospital mortality. Conclusion: Results indicated that the FOUR score is more capable than GCS in predicting the mortality and discharge of patients admitted to the PICU.

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