title: Predicting the outcome in children with head trauma: comparison of FOUR score and Glasgow Coma Scale.
abstract: BACKGROUND
  Because of the limitations of the Glasgow Coma Scale (GCS), many scoring systems have emerged and been compared with GCS. Herein, we investigated whether the Full Outline of Unresponsiveness (FOUR) score is better than GCS in predicting morbidity and mortality in children with head trauma.
  
  
  METHODS
  Patients 2-17 years of age who admitted to the emergency department with head trauma and presented with altered level of consciousness were included in this study. In-hospital mortality, hospitalization of more than three days, and Glasgow Outcome Score (GOS) at discharge and after three months were used as the primary outcome measures.
  
  
  RESULTS
  A total of 100 children were included in the study. The median age was 6 years, and 69% were male. The in-hospital mortality rate was 10%. The cut-off values for predicting in-hospital mortality were 9 for FOUR score and 7 for GCS. Area under the curve (AUC) values in predicting in-hospital mortality, poor GOS (score of 1-3) at discharge, and poor GOS after three months were similar for GCS and FOUR score.
  
  
  CONCLUSIONS
  FOUR score provides no significant advantage over GCS in predicting morbidity and mortality in children with head trauma.
authors.affiliation: Department of Emergency Medicine, Dışkapı Yıldırım Beyazıt Training and Research Hospital, Ankara, Turkey. fatihbuyukcam@gmail.com
authors.forename: Fatih
authors.initials: F
authors.lastname: Büyükcam
authors.forename: Ural
authors.initials: U
authors.lastname: Kaya
authors.forename: Muhamed Evvah
authors.initials: ME
authors.lastname: Karakılıç
authors.forename: Umut Yücel
authors.initials: UY
authors.lastname: Cavuş
authors.forename: Feruza
authors.initials: F
authors.lastname: Turan Sönmez
authors.forename: Oner
authors.initials: O
authors.lastname: Odabaş
mesh_terms: D000293:Adolescent; D019540:Area Under Curve; D002648:Child; D002675:Child, Preschool; D006259:Craniocerebral Trauma / Q000175:diagnosis* / Q000401:mortality*; D005260:Female; D015600:Glasgow Coma Scale / Q000592:standards*; D023261:Glasgow Outcome Scale; D006801:Humans; D007902:Length of Stay; D008297:Male; D009017:Morbidity; D011446:Prospective Studies; D012372:ROC Curve; D015599:Trauma Severity Indices