Full Outline of UnResponsiveness (FOUR) score

Introduction
The Glasgow Coma Scale (GCS) is widely used, but has some shortcomings including inability to test the verbal component in comatose patients, not including some variables (e.g. brainstem reflexes, breathing patterns), and not being sensitive to subtle changes in neurological examination. As such, the FOUR score was developed. Comparisons with Glasgow Coma Scale for prediction of mortality.

Both the FOUR score and the GCS can be used to predict mortality. In a study of 359 patients presenting to a hospital in Uganda with altered consciousness, the scores were comparable to each other in their abilities to predict this (FOUR score AUROC 0.68, GCS AUROC 0.67).