SynthesisEuropean journal of trauma and emergency surgery : official publication of the European Trauma Society2023
Comparison of Glasgow Coma Scale and Full Outline of UnResponsiveness score for prediction of in-hospital mortality in traumatic brain injury patients: a systematic review and meta-analysis.
Synthesis in European journal of trauma and emergency surgery : official publication of the European Trauma Society, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 39 papers, 2 of them syntheses that pooled it.
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Who cites it
39 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- The Predictive Validity of the Full Outline of UnResponsiveness Score Compared to the Glasgow Coma Scale in the Intensive Care Unit: A Systematic Review.Neurocritical care · 2025Pooled it
- Prediction performance of the machine learning model in predicting mortality risk in patients with traumatic brain injuries: a systematic review and meta-analysis.BMC medical informatics and decision making · 2023Pooled it
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- Beside Resting-State EEG in the Diagnosis and Prognosis of Patients with Disorders of Consciousness.Diagnostics (Basel, Switzerland) · 2026Article
- Early prognostication for ICU patients with combined respiratory and circulatory failure: an interpretable machine learning approach.Scientific reports · 2026Article
- Elastic functional Cox regression model with shape predictors.Journal of applied statistics · 2026Article
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- Prognostic Factors of 30-Day In-Hospital Mortality in Critically Ill Patients Receiving Continuous Renal Replacement Therapy.The journal of nursing research : JNR · 2026Observational
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- Predicting head injury prognosis using clinical scores (GCS and GCS-P score).Bioinformation · 2026Article
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- The ethics of blood stewardship and quantitative futility assessments to predict certain death in neurotrauma patients.Frontiers in medicine · 2026Review
- Article
- Evaluation of Traumatic Brain Injury Severity Using the Abbreviated Injury Scale and the Injury Severity Score: A Retrospective Study in Two Eastern European Centers.Journal of clinical medicine · 2025Article
- Interleukin-6 and its association with outcome in traumatic brain injury: a prospective cohort.Scandinavian journal of trauma, resuscitation and emergency medicine · 2025Article
- Glasgow Coma Scale Score at Admission in Traumatic Brain Injury Patients: A Multicenter Observational Analysis.Journal of clinical medicine · 2025Article
- Clinical Assessment on Days 1-14 for the Characterization of Traumatic Brain Injury: Recommendations from the 2024 NINDS Traumatic Brain Injury Classification and Nomenclature Initiative Clinical/Symptoms Working Group.Journal of neurotrauma · 2025Review
- Severe Traumatic Brain Injuries and Associated Outcomes at a Level 1 Trauma Center.Biomedicines · 2025Article
Corrections and comments
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Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundCurrently, Glasgow Coma Scale (GCS) is used to assess patients' level of consciousness. Although this tool is highly popular in clinical settings, it has various limitations that reduce its applicability in certain situations. This had led researchers to look for alternative scoring systems. This study aims to compare the value of GCS and Full Outline of UnResponsiveness (FOUR) score for prediction of mortality in traumatic brain injury (TBI) patients through a systematic review and meta-analysis.
methodOnline databases of Medline, Embase, Scopus, and Web of Science were searched until the end of July 2022 for studies that had compared GCS and FOUR score in TBI patients. Interested outcomes were mortality and unfavorable outcome (mortality + disability). Findings are reported as area under the curve (AUC) sensitivity, specificity, and diagnostic odds ratio.
results20 articles (comprised of 2083 patients) were included in this study. AUC of GCS and FOUR score for prediction of in-hospital mortality after TBI was 0.92 (95% CI 0.80-0.91) and 0.91 (95% CI 0.88-0.93) respectively. The diagnostic odds ratio of the two scores for prediction of in-hospital mortality after TBI was 44.51 (95% CI 23.58-84.03) for GCS and 45.16 (95% CI 24.25-84.09) for FOUR score. As for prediction of unfavorable outcome after TBI, AUC of GCS and FOUR score were 0.95 (95% CI 0.93 to 0.97) and 0.93 (95% CI 0.91-0.95), respectively. The diagnostic odds ratios for prediction of unfavorable outcome after TBI were 66.31 (95% CI 35.05-125.45) for GCS and 45.39 (95% CI 23.09-89.23) for FOUR score.
conclusionModerate level of evidence showed that the value of GCS and FOUR score in the prediction of in-hospital mortality and unfavorable outcome is comparable. The similar performance of these scores in assessment of TBI patients gives the medical staff the option to use either one of them according to the situation at hand.
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