Treatment and rehabilitation of patients with acute cerebral insufficiency necessitate critical objectives (assessment of brain damage severity and prediction of potential outcomes). Despite the role of this stage, current consciousness assessment methods often lack sufficient accuracy and objectivity. A promising approach is the Full Outline of UnResponsiveness scale (FOUR) providing objective patient evaluation compared to traditional Glasgow Coma scale.

OBJECTIVE

To evaluate clinical significance of the FOUR scale for patients with cerebral insufficiency.

MATERIAL AND METHODS

A prospective single-center study included 200 patients with acute cerebral insufficiency. Analysis employed ROC curves, logistic regression and correlation methods.

RESULTS

The FOUR scale demonstrated high prognostic accuracy in comatose patients (AUC=0.944 vs. 0.742 for GCS, p< 0.001). Strong correlations were found between FOUR scores and GOS grades (rs=0.7546, p<0.0001), as well as prediction of mortality (OR=3.4, 95% CI 2.1—5.6). For patients with chronic consciousness disorders, the FOUR scale showed benefits (AUC=0.936 vs. 0.745 for GCS).

CONCLUSION

The FOUR scale represents an optimal monitoring tool for patients with cerebral insufficiency.