Abstract

Adequate initial assessment and early intervention are of paramount importance in treating patients with Traumatic brain injury. Assessing the level of consciousness is a complex and difficult affair, mostly due to the difficulty in finding appropriate terminologies. Present study aimed to evaluate the correlation between FOUR score and GCS in evaluating the level of consciousness, initial status and determining the outcome among patients with head injuries. Material and method- This comparative study was conducted at the Department of General Surgery, Rajindra Hospital, Patiala, including 70 patients presenting to the emergency surgery ward from March 2021 to December 2022. A structured proforma was used to enter the detailed history, mode, and mechanism of trauma, vitals, and to chart the GCS SCORE and FOUR SCORE at presentation, one hour, six hours, and 24 hours after obtaining consent at the time of admission. Observation and method Pulse rate was the most important and sensitive vital followed by oxygen saturation with a p-value of 0.002 and P-value of 0.036 respectively, in determining the outcome of TBI. Most TBIs can be managed conservatively and do not need operative intervention. As in our study, 92.9% n=65 was managed conservatively and only 7.1% n=5 patients required any sort of operative procedure related to TBI. Conclusion Both scoring systems have good and comparable prediction values to each other, but the FOUR score performed better at presentation. FOUR score also has added benefit of assessing brainstem reflexes and respiration and does not have a dependence on verbal response

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