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International Journal of Neurology and Neurosurgery

Volume  12, Issue 2, April-June 2020, Pages 75-79
 

Original Article

Novel Modification of Four To Four-P Score: A Comparative Analysis with GCS in Head Injury Patients with Poly Trauma

Ashirwad Karigoudar1, A Thiruvalluvan2, Sudhakar Kasinathan3

1Resident, 2Director and Head of Institute, 3Assistant Professor, Department of Neurosurgery, Madras Medical College and Rajiv Gandhi Government General Hospital, Chennai, Tamil Nadu

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DOI: http://dx.doi.org/10.21088/ijnns.0975.0223.12220.2

Abstract

Overview: Head injuries are among the leading cause of morbidity and mortality across the world. Adequate, expeditious assessment and early intervention is of utmost importance for favorable outcome in patients with head injury. GCS and FOUR score are the widely accepted tool to quickly assess the severity in head injury patients and prognosticate, albeit with limitations. The objective of this study was to test the adequacy of FOUR-P score, as an alternative tool, to assess the severity and prognosticate the patients with head injury in poly trauma patients. Methods and Materials: This was a comparative study, conducted on 100 patients of poly trauma admitted to the trauma ward of Madras Medical College, Chennai. For all these patients, FOUR and FOUR-P score and GCS were calculated at the time of presentation and at 1st hour, 6th hour, 24th hour. The predictive value of FOUR-P score as well as its correlation with FOUR score and GCS was studied. Results: A statistically significant assessment and prognostication could be made using FOUR-P score when compared to FOUR score and GCS. Also FOUR-P was able to furnish better details about the neurological status of poly trauma patients. Conclusion: As per the results, it can be concluded that the FOUR-P score can be applied as an ideal tool for initial evaluation and prognostication in patients with poly trauma. It can be used as the ideal replacement for FOUR score and GCS. Further studies needed.

Keywords: FOUR and FOUR-P score; GCS; Poly trauma; Head injury.
 


Corresponding Author : A Thiruvalluvan