原创力文档inter-rater reliability of the full outline of unresponsiveness score and the glasgow coma scale in critically ill patients a prospective observational study两分的完整轮廓的无响应可靠性得分和格拉斯哥昏迷评分危重患者的前瞻性研究.pdfVIP
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inter-rater reliability of the full outline of unresponsiveness score and the glasgow coma scale in critically ill patients a prospective observational study两分的完整轮廓的无响应可靠性得分和格拉斯哥昏迷评分危重患者的前瞻性研究
Fischer et al. Critical Care 2010, 14:R64
/content/14/2/R64
R E S E A R C H Open Access
Research
Inter-rater reliability of the Full Outline of
UnResponsiveness score and the Glasgow Coma
Scale in critically ill patients: a prospective
observational study
1 2 2 1 1 3
Michael Fischer , Stephan Rüegg , Adam Czaplinski , Monika Strohmeier , Angelika Lehmann , Franziska Tschan ,
Patrick R Hunziker1 1
and Stephan C Marsch*
Abstract
Introduction: The Glasgow Coma Scale (GCS) is the most widely used scoring system for comatose patients in
intensive care. Limitations of the GCS include the impossibility to assess the verbal score in intubated or aphasic
patients, and an inconsistent inter-rater reliability. The FOUR (Full Outline of UnResponsiveness) score, a new coma
scale not reliant on verbal response, was recently proposed. The aim of the present study was to compare the inter-
rater reliability of the GCS and the FOUR score among unselected patients in general critical care. A further aim was to
compare the inter-rater reliability of neurologists with that of intensive care unit (ICU) staff.
Methods: In this prospective observational study, scoring of GCS and FOUR score was performed by neurologists and
ICU staff on 267 consecutive patients admitted to intensive care.
Results: In a total of 437 pair wise ratings the exact inter-rater agreement for the GCS was 71%, and for the FOUR score
82% (P = 0.0016); the inter-rater agreement within a range of ± 1 score point for the GCS was 90%, and for the FOUR
score 92% (P = ns.). The exact inter-rater agreement among neurologists was superior to that among ICU staff for the
FOUR scor
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