The FOUR score predicts outcome in patients after cardiac arrest.

Neurocritical Care
Jennifer E FugateE F M Wijdicks

Abstract

Prognostication for survivors of cardiac arrest is a frequent challenge to neurologists. Our aim was to determine whether the FOUR (Full Outline of UnResponsiveness) score is an accurate predictor of outcome in patients after cardiac arrest and to compare its performance to the Glasgow Coma Scale (GCS). We prospectively identified patients surviving cardiac arrest from June 2006 to October 2009. Neurologic exams were grouped into two time intervals following cardiac arrest: 1-2 days and 3-5 days. The FOUR score and the Glasgow coma scale (GCS) were determined for each examination. Primary outcome was in-hospital mortality. Of 136 patients, 112 (82%) were examined on days 1-2 after cardiac arrest and 87 (64%) on days 3-5. Forty-seven patients (35%) survived to hospital discharge and 89 (65%) died during hospitalization. No patients with a sum FOUR score ≤ 4 at exam days 3-5 survived (false positive rate [FPR] 0% C.I. 0.000-0.0345), whereas one patient (2%) with sum GCS score of 3 survived to discharge (FPR 2.2%, C.I. < 0.0001-0.1758). At days 3-5 after arrest, 41 of 45 (91%) patients with a sum FOUR score > 8 survived (P < 0.0001), while 39 of 45 (87%) with a sum GCS > 6 survived (P < 0.0001). A 2-point improvement in FOUR score...Continue Reading

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Citations

Jun 4, 2011·Internal and Emergency Medicine·Luis A Idrovo Freire
Aug 17, 2011·Neurocritical Care·Farid SadakaRekha Lakshmanan
Mar 17, 2012·Resuscitation·David SzpilmanRicardo Turon Costa da Silva
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Sep 12, 2014·Neurocritical Care·Richard R RikerUNKNOWN Participants in the International Multi-disciplinary Consensus Conference on Multimodality Monitoring
May 31, 2016·Journal of Intensive Care·Yasuhiro Kuroda
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Jul 19, 2017·Circulation. Cardiovascular Quality and Outcomes·Ahamed H IdrisMary Fran Hazinski
Dec 6, 2018·Continuum : Lifelong Learning in Neurology·Alejandro A Rabinstein
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Nov 23, 2016·Neurocritical Care·Tee-Tau Eric NyamJinn-Rung Kuo
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May 3, 2019·Journal of Neurotrauma·Ching C FooPaul M Brennan
Jan 27, 2017·World Journal of Emergency Medicine·Atahar JamalPratibha Singhi

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