285 Original Investigation DOI: 10.5137/1019-5149.JTN.24175-18.2 Received: 03.07.2018 / Accepted: 12.10.2018 Published Online: 26.11.2018 Corresponding author: Yesim Serife BAYRAKTAR  yesimbayraktar1983@hotmail.com Turk Neurosurg 29(2):285-288, 2019 Yesim Serife BAYRAKTAR¹, Mert SAHINOGLU², Faruk CICEKCI¹, Inci KARA¹, Hakan KARABAGLI², Ates DUMAN¹, Jale Bengi CELIK¹ 1 Selcuk University, School of Medicine, Department of Anesthesiology and Reanimation, Konya, Turkey 2 Selcuk University, School of Medicine, Department of Neurosurgery, Konya, Turkey This study has been presented at the 32 nd Scientifc Congress of Turkish Neurosurgical Society between 20 and 24 April 2018 at Antalya, Turkey Comparison of Glasgow Coma Scale and Full Outline of Unresponsiveness (Four) Score: A Prospective Study ABSTRACT the scale, and it does not factor in the patient’s respiratory pattern (3). Early changes in consciousness associated with deviations in respiratory pattern and brain stem refexes may not be recognized. Therefore, in 2005 Wijdicks et al. developed the Full Outline of Unresponsiveness (FOUR) as a modifcation of the GCS (11). Because this scale must also be understood correctly and applied as accurately as possible in Turkey, Orken et al. conducted a reliability study on the Turkish version of the FOUR score in 2010 (8). These scales are a key tool in modifying interventions and treatment plans, particularly for unconscious patients, and scales are user-dependent to some degree. For this reason, comparative █ INTRODUCTION S coring systems are often used in intensive care settings to assess level of consciousness (6,10). Scales were developed to allow health professionals to describe the general condition, neurological status, and cardiopulmonary status of patients to one another in a succinct and standard way (2,5,9,10). Of these, the Glasgow Coma Scale (GCS) is the most commonly used (3,4,8,9). However, the GCS has several disadvantages. Its use is limited when verbal responses cannot be assessed, especially in intubated and aphasic patients, brain stem refexes are not incorporated in AIM: To assess reliability by comparing the Full Outline of Unresponsiveness (FOUR) scores and Glasgow Coma Scale (GCS) values assigned by specialists from two diferent felds to patients in the Anesthesiology and Reanimation and Neurosurgery intensive care units. MATERIAL and METHODS: This study was conducted between March 2017 and June 2017 at Selcuk University Faculty of Medicine, Departments of Anesthesiology and Reanimation and Neurosurgery. Seventy-nine patients aged 18-65 years who were treated for at least 24 hours in the intensive care unit were independently assessed by two raters, an anesthesiologist and a neurosurgeon,using FOUR and GCS. The Kolmogorov-Smirnov normality test was applied for continuous variables, and SPSS 20.0 version software was used for data analyses. RESULTS: There were no signifcant diferences between FOUR scores and GCS values given by the two raters. The mortality rate among patients with low scores on both FOUR and GCS was higher than the hospital mortality rate. CONCLUSION: Considering that FOUR score allows a more detailed neurological evaluation than GCS, and our fndings suggest that FOUR score is more useful for patients who are unconscious or dependent on mechanical ventilation. KEYWORDS: Consciousness, Full outline of unresponsiveness, FOUR, Glasgow coma scale, GCS Yesim Serife BAYRAKTAR : 0000-0001-5156-7064 Mert SAHINOGLU : 0000-0003-0633-8304 Faruk CICEKCI : 0000-0002-3248-0745 Inci KARA : 0000-0001-6546-4277 Hakan KARABAGLI : 0000-0002-1184-3965 Ates DUMAN : 0000-0003-0394-2485 Jale Bengi CELIK : 0000-0003-2167-9967