FOUR Score, a Reliable Score for Assessing Overt Hepatic Encephalopathy in Cirrhotic Patients

Background Hepatic encephalopathy (HE) is a frequent complication of cirrhosis and a major public health problem. The incidence is increasing because of improved cirrhosis prognosis. The most widely used scale used to evaluate HE is the West-Haven (WH) scale, with scores ranging from 0 to 4. This sc...
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Autor*in:	Mouri, Sarah [verfasserIn] Tripon, Simona [verfasserIn] Rudler, Marika [verfasserIn] Mallet, Maxime [verfasserIn] Mayaux, Julien [verfasserIn] Thabut, Dominique [verfasserIn] Weiss, Nicolas [verfasserIn]

Format:	E-Artikel
Sprache:	Englisch

Erschienen:	2014

Schlagwörter:	Hepatic encephalopathy Cirrhosis Coma FOUR score Glasgow coma scale

Übergeordnetes Werk:	Enthalten in: Neurocritical care - New York, NY : Springer, 2004, 22(2014), 2 vom: 21. Okt., Seite 251-257
Übergeordnetes Werk:	volume:22 ; year:2014 ; number:2 ; day:21 ; month:10 ; pages:251-257

Links:	Volltext

DOI / URN:	10.1007/s12028-014-0078-5

Katalog-ID:	SPR02381117X

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520			\|a Background Hepatic encephalopathy (HE) is a frequent complication of cirrhosis and a major public health problem. The incidence is increasing because of improved cirrhosis prognosis. The most widely used scale used to evaluate HE is the West-Haven (WH) scale, with scores ranging from 0 to 4. This scale is easy to use but not suitable for patients with altered consciousness and is not well known by physicians other than hepatologists who manage these conditions. For deep coma, the validated Glasgow Coma Scale (GCS) has been proposed. A new scale for comatose patients, the Full Outline of UnResponsiveness (FOUR) score, has recently been proposed and widely validated. The scale covers eye and motor responses, brainstem reflexes and breathing patterns and is the most validated coma scale. Objective To assess the diagnostic value of the FOUR score for detecting overt HE (OHE) in cirrhotic patients. Methods We prospectively included all patients admitted for cirrhosis at La Pitié-Salpêtrière Hospital from June 2012 to March 2014. Neurological status was assessed by a senior neurologic intensive care physician in the 24 first hours of ICU admission. The recently described and validated French version of the FOUR score was used. Results We screened 100 cirrhotic patients and included 94 (70 males [75 %], mean age 57 ± 11 years): 29 (31 %) with OHE (WH grades 2–4) and 65 (69 %) with No-OHE (WH grades 0–1). Mean FOUR and GCS scores were lower for OHE than No-OHE patients (p < 0.0001). The FOUR score could distinguish between WH grades 0–1, 2–3 and 4 (p < 0.0001). Furthermore, it could accurately detect and quantify OHE with an area under the c-index of 0.88 ± 0.10. The FOUR score was associated with outcome. Conclusion The FOUR score can be used to detect and quantify HE in cirrhotic patients, especially by non-hepatologists who are not familiar with the WH scale.
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700	1		\|a Mayaux, Julien \|e verfasserin \|4 aut
700	1		\|a Thabut, Dominique \|e verfasserin \|4 aut
700	1		\|a Weiss, Nicolas \|e verfasserin \|4 aut
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allfields	10.1007/s12028-014-0078-5 doi (DE-627)SPR02381117X (SPR)s12028-014-0078-5-e DE-627 ger DE-627 rakwb eng 610 ASE 44.90 bkl Mouri, Sarah verfasserin aut FOUR Score, a Reliable Score for Assessing Overt Hepatic Encephalopathy in Cirrhotic Patients 2014 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Background Hepatic encephalopathy (HE) is a frequent complication of cirrhosis and a major public health problem. The incidence is increasing because of improved cirrhosis prognosis. The most widely used scale used to evaluate HE is the West-Haven (WH) scale, with scores ranging from 0 to 4. This scale is easy to use but not suitable for patients with altered consciousness and is not well known by physicians other than hepatologists who manage these conditions. For deep coma, the validated Glasgow Coma Scale (GCS) has been proposed. A new scale for comatose patients, the Full Outline of UnResponsiveness (FOUR) score, has recently been proposed and widely validated. The scale covers eye and motor responses, brainstem reflexes and breathing patterns and is the most validated coma scale. Objective To assess the diagnostic value of the FOUR score for detecting overt HE (OHE) in cirrhotic patients. Methods We prospectively included all patients admitted for cirrhosis at La Pitié-Salpêtrière Hospital from June 2012 to March 2014. Neurological status was assessed by a senior neurologic intensive care physician in the 24 first hours of ICU admission. The recently described and validated French version of the FOUR score was used. Results We screened 100 cirrhotic patients and included 94 (70 males [75 %], mean age 57 ± 11 years): 29 (31 %) with OHE (WH grades 2–4) and 65 (69 %) with No-OHE (WH grades 0–1). Mean FOUR and GCS scores were lower for OHE than No-OHE patients (p < 0.0001). The FOUR score could distinguish between WH grades 0–1, 2–3 and 4 (p < 0.0001). Furthermore, it could accurately detect and quantify OHE with an area under the c-index of 0.88 ± 0.10. The FOUR score was associated with outcome. Conclusion The FOUR score can be used to detect and quantify HE in cirrhotic patients, especially by non-hepatologists who are not familiar with the WH scale. Hepatic encephalopathy (dpeaa)DE-He213 Cirrhosis (dpeaa)DE-He213 Coma (dpeaa)DE-He213 FOUR score (dpeaa)DE-He213 Glasgow coma scale (dpeaa)DE-He213 Tripon, Simona verfasserin aut Rudler, Marika verfasserin aut Mallet, Maxime verfasserin aut Mayaux, Julien verfasserin aut Thabut, Dominique verfasserin aut Weiss, Nicolas verfasserin aut Enthalten in Neurocritical care New York, NY : Springer, 2004 22(2014), 2 vom: 21. Okt., Seite 251-257 (DE-627)478509855 (DE-600)2176033-0 1556-0961 nnns volume:22 year:2014 number:2 day:21 month:10 pages:251-257 https://dx.doi.org/10.1007/s12028-014-0078-5 lizenzpflichtig Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_32 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_95 GBV_ILN_100 GBV_ILN_101 GBV_ILN_105 GBV_ILN_110 GBV_ILN_120 GBV_ILN_138 GBV_ILN_150 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_171 GBV_ILN_187 GBV_ILN_213 GBV_ILN_224 GBV_ILN_230 GBV_ILN_250 GBV_ILN_281 GBV_ILN_285 GBV_ILN_293 GBV_ILN_370 GBV_ILN_602 GBV_ILN_636 GBV_ILN_702 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2004 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2007 GBV_ILN_2008 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2026 GBV_ILN_2027 GBV_ILN_2031 GBV_ILN_2034 GBV_ILN_2037 GBV_ILN_2038 GBV_ILN_2039 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2049 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2057 GBV_ILN_2059 GBV_ILN_2061 GBV_ILN_2064 GBV_ILN_2065 GBV_ILN_2068 GBV_ILN_2070 GBV_ILN_2086 GBV_ILN_2088 GBV_ILN_2093 GBV_ILN_2106 GBV_ILN_2107 GBV_ILN_2108 GBV_ILN_2110 GBV_ILN_2111 GBV_ILN_2112 GBV_ILN_2113 GBV_ILN_2116 GBV_ILN_2118 GBV_ILN_2119 GBV_ILN_2122 GBV_ILN_2129 GBV_ILN_2143 GBV_ILN_2144 GBV_ILN_2147 GBV_ILN_2148 GBV_ILN_2152 GBV_ILN_2153 GBV_ILN_2188 GBV_ILN_2190 GBV_ILN_2232 GBV_ILN_2336 GBV_ILN_2446 GBV_ILN_2470 GBV_ILN_2472 GBV_ILN_2507 GBV_ILN_2522 GBV_ILN_2548 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4046 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4242 GBV_ILN_4246 GBV_ILN_4249 GBV_ILN_4251 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4326 GBV_ILN_4333 GBV_ILN_4334 GBV_ILN_4335 GBV_ILN_4336 GBV_ILN_4338 GBV_ILN_4393 GBV_ILN_4700 44.90 ASE AR 22 2014 2 21 10 251-257
spelling	10.1007/s12028-014-0078-5 doi (DE-627)SPR02381117X (SPR)s12028-014-0078-5-e DE-627 ger DE-627 rakwb eng 610 ASE 44.90 bkl Mouri, Sarah verfasserin aut FOUR Score, a Reliable Score for Assessing Overt Hepatic Encephalopathy in Cirrhotic Patients 2014 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Background Hepatic encephalopathy (HE) is a frequent complication of cirrhosis and a major public health problem. The incidence is increasing because of improved cirrhosis prognosis. The most widely used scale used to evaluate HE is the West-Haven (WH) scale, with scores ranging from 0 to 4. This scale is easy to use but not suitable for patients with altered consciousness and is not well known by physicians other than hepatologists who manage these conditions. For deep coma, the validated Glasgow Coma Scale (GCS) has been proposed. A new scale for comatose patients, the Full Outline of UnResponsiveness (FOUR) score, has recently been proposed and widely validated. The scale covers eye and motor responses, brainstem reflexes and breathing patterns and is the most validated coma scale. Objective To assess the diagnostic value of the FOUR score for detecting overt HE (OHE) in cirrhotic patients. Methods We prospectively included all patients admitted for cirrhosis at La Pitié-Salpêtrière Hospital from June 2012 to March 2014. Neurological status was assessed by a senior neurologic intensive care physician in the 24 first hours of ICU admission. The recently described and validated French version of the FOUR score was used. Results We screened 100 cirrhotic patients and included 94 (70 males [75 %], mean age 57 ± 11 years): 29 (31 %) with OHE (WH grades 2–4) and 65 (69 %) with No-OHE (WH grades 0–1). Mean FOUR and GCS scores were lower for OHE than No-OHE patients (p < 0.0001). The FOUR score could distinguish between WH grades 0–1, 2–3 and 4 (p < 0.0001). Furthermore, it could accurately detect and quantify OHE with an area under the c-index of 0.88 ± 0.10. The FOUR score was associated with outcome. Conclusion The FOUR score can be used to detect and quantify HE in cirrhotic patients, especially by non-hepatologists who are not familiar with the WH scale. Hepatic encephalopathy (dpeaa)DE-He213 Cirrhosis (dpeaa)DE-He213 Coma (dpeaa)DE-He213 FOUR score (dpeaa)DE-He213 Glasgow coma scale (dpeaa)DE-He213 Tripon, Simona verfasserin aut Rudler, Marika verfasserin aut Mallet, Maxime verfasserin aut Mayaux, Julien verfasserin aut Thabut, Dominique verfasserin aut Weiss, Nicolas verfasserin aut Enthalten in Neurocritical care New York, NY : Springer, 2004 22(2014), 2 vom: 21. Okt., Seite 251-257 (DE-627)478509855 (DE-600)2176033-0 1556-0961 nnns volume:22 year:2014 number:2 day:21 month:10 pages:251-257 https://dx.doi.org/10.1007/s12028-014-0078-5 lizenzpflichtig Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_32 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_95 GBV_ILN_100 GBV_ILN_101 GBV_ILN_105 GBV_ILN_110 GBV_ILN_120 GBV_ILN_138 GBV_ILN_150 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_171 GBV_ILN_187 GBV_ILN_213 GBV_ILN_224 GBV_ILN_230 GBV_ILN_250 GBV_ILN_281 GBV_ILN_285 GBV_ILN_293 GBV_ILN_370 GBV_ILN_602 GBV_ILN_636 GBV_ILN_702 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2004 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2007 GBV_ILN_2008 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2026 GBV_ILN_2027 GBV_ILN_2031 GBV_ILN_2034 GBV_ILN_2037 GBV_ILN_2038 GBV_ILN_2039 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2049 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2057 GBV_ILN_2059 GBV_ILN_2061 GBV_ILN_2064 GBV_ILN_2065 GBV_ILN_2068 GBV_ILN_2070 GBV_ILN_2086 GBV_ILN_2088 GBV_ILN_2093 GBV_ILN_2106 GBV_ILN_2107 GBV_ILN_2108 GBV_ILN_2110 GBV_ILN_2111 GBV_ILN_2112 GBV_ILN_2113 GBV_ILN_2116 GBV_ILN_2118 GBV_ILN_2119 GBV_ILN_2122 GBV_ILN_2129 GBV_ILN_2143 GBV_ILN_2144 GBV_ILN_2147 GBV_ILN_2148 GBV_ILN_2152 GBV_ILN_2153 GBV_ILN_2188 GBV_ILN_2190 GBV_ILN_2232 GBV_ILN_2336 GBV_ILN_2446 GBV_ILN_2470 GBV_ILN_2472 GBV_ILN_2507 GBV_ILN_2522 GBV_ILN_2548 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4046 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4242 GBV_ILN_4246 GBV_ILN_4249 GBV_ILN_4251 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4326 GBV_ILN_4333 GBV_ILN_4334 GBV_ILN_4335 GBV_ILN_4336 GBV_ILN_4338 GBV_ILN_4393 GBV_ILN_4700 44.90 ASE AR 22 2014 2 21 10 251-257
allfields_unstemmed	10.1007/s12028-014-0078-5 doi (DE-627)SPR02381117X (SPR)s12028-014-0078-5-e DE-627 ger DE-627 rakwb eng 610 ASE 44.90 bkl Mouri, Sarah verfasserin aut FOUR Score, a Reliable Score for Assessing Overt Hepatic Encephalopathy in Cirrhotic Patients 2014 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Background Hepatic encephalopathy (HE) is a frequent complication of cirrhosis and a major public health problem. The incidence is increasing because of improved cirrhosis prognosis. The most widely used scale used to evaluate HE is the West-Haven (WH) scale, with scores ranging from 0 to 4. This scale is easy to use but not suitable for patients with altered consciousness and is not well known by physicians other than hepatologists who manage these conditions. For deep coma, the validated Glasgow Coma Scale (GCS) has been proposed. A new scale for comatose patients, the Full Outline of UnResponsiveness (FOUR) score, has recently been proposed and widely validated. The scale covers eye and motor responses, brainstem reflexes and breathing patterns and is the most validated coma scale. Objective To assess the diagnostic value of the FOUR score for detecting overt HE (OHE) in cirrhotic patients. Methods We prospectively included all patients admitted for cirrhosis at La Pitié-Salpêtrière Hospital from June 2012 to March 2014. Neurological status was assessed by a senior neurologic intensive care physician in the 24 first hours of ICU admission. The recently described and validated French version of the FOUR score was used. Results We screened 100 cirrhotic patients and included 94 (70 males [75 %], mean age 57 ± 11 years): 29 (31 %) with OHE (WH grades 2–4) and 65 (69 %) with No-OHE (WH grades 0–1). Mean FOUR and GCS scores were lower for OHE than No-OHE patients (p < 0.0001). The FOUR score could distinguish between WH grades 0–1, 2–3 and 4 (p < 0.0001). Furthermore, it could accurately detect and quantify OHE with an area under the c-index of 0.88 ± 0.10. The FOUR score was associated with outcome. Conclusion The FOUR score can be used to detect and quantify HE in cirrhotic patients, especially by non-hepatologists who are not familiar with the WH scale. Hepatic encephalopathy (dpeaa)DE-He213 Cirrhosis (dpeaa)DE-He213 Coma (dpeaa)DE-He213 FOUR score (dpeaa)DE-He213 Glasgow coma scale (dpeaa)DE-He213 Tripon, Simona verfasserin aut Rudler, Marika verfasserin aut Mallet, Maxime verfasserin aut Mayaux, Julien verfasserin aut Thabut, Dominique verfasserin aut Weiss, Nicolas verfasserin aut Enthalten in Neurocritical care New York, NY : Springer, 2004 22(2014), 2 vom: 21. Okt., Seite 251-257 (DE-627)478509855 (DE-600)2176033-0 1556-0961 nnns volume:22 year:2014 number:2 day:21 month:10 pages:251-257 https://dx.doi.org/10.1007/s12028-014-0078-5 lizenzpflichtig Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_32 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_95 GBV_ILN_100 GBV_ILN_101 GBV_ILN_105 GBV_ILN_110 GBV_ILN_120 GBV_ILN_138 GBV_ILN_150 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_171 GBV_ILN_187 GBV_ILN_213 GBV_ILN_224 GBV_ILN_230 GBV_ILN_250 GBV_ILN_281 GBV_ILN_285 GBV_ILN_293 GBV_ILN_370 GBV_ILN_602 GBV_ILN_636 GBV_ILN_702 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2004 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2007 GBV_ILN_2008 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2026 GBV_ILN_2027 GBV_ILN_2031 GBV_ILN_2034 GBV_ILN_2037 GBV_ILN_2038 GBV_ILN_2039 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2049 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2057 GBV_ILN_2059 GBV_ILN_2061 GBV_ILN_2064 GBV_ILN_2065 GBV_ILN_2068 GBV_ILN_2070 GBV_ILN_2086 GBV_ILN_2088 GBV_ILN_2093 GBV_ILN_2106 GBV_ILN_2107 GBV_ILN_2108 GBV_ILN_2110 GBV_ILN_2111 GBV_ILN_2112 GBV_ILN_2113 GBV_ILN_2116 GBV_ILN_2118 GBV_ILN_2119 GBV_ILN_2122 GBV_ILN_2129 GBV_ILN_2143 GBV_ILN_2144 GBV_ILN_2147 GBV_ILN_2148 GBV_ILN_2152 GBV_ILN_2153 GBV_ILN_2188 GBV_ILN_2190 GBV_ILN_2232 GBV_ILN_2336 GBV_ILN_2446 GBV_ILN_2470 GBV_ILN_2472 GBV_ILN_2507 GBV_ILN_2522 GBV_ILN_2548 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4046 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4242 GBV_ILN_4246 GBV_ILN_4249 GBV_ILN_4251 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4326 GBV_ILN_4333 GBV_ILN_4334 GBV_ILN_4335 GBV_ILN_4336 GBV_ILN_4338 GBV_ILN_4393 GBV_ILN_4700 44.90 ASE AR 22 2014 2 21 10 251-257
allfieldsGer	10.1007/s12028-014-0078-5 doi (DE-627)SPR02381117X (SPR)s12028-014-0078-5-e DE-627 ger DE-627 rakwb eng 610 ASE 44.90 bkl Mouri, Sarah verfasserin aut FOUR Score, a Reliable Score for Assessing Overt Hepatic Encephalopathy in Cirrhotic Patients 2014 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Background Hepatic encephalopathy (HE) is a frequent complication of cirrhosis and a major public health problem. The incidence is increasing because of improved cirrhosis prognosis. The most widely used scale used to evaluate HE is the West-Haven (WH) scale, with scores ranging from 0 to 4. This scale is easy to use but not suitable for patients with altered consciousness and is not well known by physicians other than hepatologists who manage these conditions. For deep coma, the validated Glasgow Coma Scale (GCS) has been proposed. A new scale for comatose patients, the Full Outline of UnResponsiveness (FOUR) score, has recently been proposed and widely validated. The scale covers eye and motor responses, brainstem reflexes and breathing patterns and is the most validated coma scale. Objective To assess the diagnostic value of the FOUR score for detecting overt HE (OHE) in cirrhotic patients. Methods We prospectively included all patients admitted for cirrhosis at La Pitié-Salpêtrière Hospital from June 2012 to March 2014. Neurological status was assessed by a senior neurologic intensive care physician in the 24 first hours of ICU admission. The recently described and validated French version of the FOUR score was used. Results We screened 100 cirrhotic patients and included 94 (70 males [75 %], mean age 57 ± 11 years): 29 (31 %) with OHE (WH grades 2–4) and 65 (69 %) with No-OHE (WH grades 0–1). Mean FOUR and GCS scores were lower for OHE than No-OHE patients (p < 0.0001). The FOUR score could distinguish between WH grades 0–1, 2–3 and 4 (p < 0.0001). Furthermore, it could accurately detect and quantify OHE with an area under the c-index of 0.88 ± 0.10. The FOUR score was associated with outcome. Conclusion The FOUR score can be used to detect and quantify HE in cirrhotic patients, especially by non-hepatologists who are not familiar with the WH scale. Hepatic encephalopathy (dpeaa)DE-He213 Cirrhosis (dpeaa)DE-He213 Coma (dpeaa)DE-He213 FOUR score (dpeaa)DE-He213 Glasgow coma scale (dpeaa)DE-He213 Tripon, Simona verfasserin aut Rudler, Marika verfasserin aut Mallet, Maxime verfasserin aut Mayaux, Julien verfasserin aut Thabut, Dominique verfasserin aut Weiss, Nicolas verfasserin aut Enthalten in Neurocritical care New York, NY : Springer, 2004 22(2014), 2 vom: 21. Okt., Seite 251-257 (DE-627)478509855 (DE-600)2176033-0 1556-0961 nnns volume:22 year:2014 number:2 day:21 month:10 pages:251-257 https://dx.doi.org/10.1007/s12028-014-0078-5 lizenzpflichtig Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_32 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_95 GBV_ILN_100 GBV_ILN_101 GBV_ILN_105 GBV_ILN_110 GBV_ILN_120 GBV_ILN_138 GBV_ILN_150 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_171 GBV_ILN_187 GBV_ILN_213 GBV_ILN_224 GBV_ILN_230 GBV_ILN_250 GBV_ILN_281 GBV_ILN_285 GBV_ILN_293 GBV_ILN_370 GBV_ILN_602 GBV_ILN_636 GBV_ILN_702 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2004 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2007 GBV_ILN_2008 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2026 GBV_ILN_2027 GBV_ILN_2031 GBV_ILN_2034 GBV_ILN_2037 GBV_ILN_2038 GBV_ILN_2039 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2049 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2057 GBV_ILN_2059 GBV_ILN_2061 GBV_ILN_2064 GBV_ILN_2065 GBV_ILN_2068 GBV_ILN_2070 GBV_ILN_2086 GBV_ILN_2088 GBV_ILN_2093 GBV_ILN_2106 GBV_ILN_2107 GBV_ILN_2108 GBV_ILN_2110 GBV_ILN_2111 GBV_ILN_2112 GBV_ILN_2113 GBV_ILN_2116 GBV_ILN_2118 GBV_ILN_2119 GBV_ILN_2122 GBV_ILN_2129 GBV_ILN_2143 GBV_ILN_2144 GBV_ILN_2147 GBV_ILN_2148 GBV_ILN_2152 GBV_ILN_2153 GBV_ILN_2188 GBV_ILN_2190 GBV_ILN_2232 GBV_ILN_2336 GBV_ILN_2446 GBV_ILN_2470 GBV_ILN_2472 GBV_ILN_2507 GBV_ILN_2522 GBV_ILN_2548 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4046 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4242 GBV_ILN_4246 GBV_ILN_4249 GBV_ILN_4251 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4326 GBV_ILN_4333 GBV_ILN_4334 GBV_ILN_4335 GBV_ILN_4336 GBV_ILN_4338 GBV_ILN_4393 GBV_ILN_4700 44.90 ASE AR 22 2014 2 21 10 251-257
allfieldsSound	10.1007/s12028-014-0078-5 doi (DE-627)SPR02381117X (SPR)s12028-014-0078-5-e DE-627 ger DE-627 rakwb eng 610 ASE 44.90 bkl Mouri, Sarah verfasserin aut FOUR Score, a Reliable Score for Assessing Overt Hepatic Encephalopathy in Cirrhotic Patients 2014 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Background Hepatic encephalopathy (HE) is a frequent complication of cirrhosis and a major public health problem. The incidence is increasing because of improved cirrhosis prognosis. The most widely used scale used to evaluate HE is the West-Haven (WH) scale, with scores ranging from 0 to 4. This scale is easy to use but not suitable for patients with altered consciousness and is not well known by physicians other than hepatologists who manage these conditions. For deep coma, the validated Glasgow Coma Scale (GCS) has been proposed. A new scale for comatose patients, the Full Outline of UnResponsiveness (FOUR) score, has recently been proposed and widely validated. The scale covers eye and motor responses, brainstem reflexes and breathing patterns and is the most validated coma scale. Objective To assess the diagnostic value of the FOUR score for detecting overt HE (OHE) in cirrhotic patients. Methods We prospectively included all patients admitted for cirrhosis at La Pitié-Salpêtrière Hospital from June 2012 to March 2014. Neurological status was assessed by a senior neurologic intensive care physician in the 24 first hours of ICU admission. The recently described and validated French version of the FOUR score was used. Results We screened 100 cirrhotic patients and included 94 (70 males [75 %], mean age 57 ± 11 years): 29 (31 %) with OHE (WH grades 2–4) and 65 (69 %) with No-OHE (WH grades 0–1). Mean FOUR and GCS scores were lower for OHE than No-OHE patients (p < 0.0001). The FOUR score could distinguish between WH grades 0–1, 2–3 and 4 (p < 0.0001). Furthermore, it could accurately detect and quantify OHE with an area under the c-index of 0.88 ± 0.10. The FOUR score was associated with outcome. Conclusion The FOUR score can be used to detect and quantify HE in cirrhotic patients, especially by non-hepatologists who are not familiar with the WH scale. Hepatic encephalopathy (dpeaa)DE-He213 Cirrhosis (dpeaa)DE-He213 Coma (dpeaa)DE-He213 FOUR score (dpeaa)DE-He213 Glasgow coma scale (dpeaa)DE-He213 Tripon, Simona verfasserin aut Rudler, Marika verfasserin aut Mallet, Maxime verfasserin aut Mayaux, Julien verfasserin aut Thabut, Dominique verfasserin aut Weiss, Nicolas verfasserin aut Enthalten in Neurocritical care New York, NY : Springer, 2004 22(2014), 2 vom: 21. Okt., Seite 251-257 (DE-627)478509855 (DE-600)2176033-0 1556-0961 nnns volume:22 year:2014 number:2 day:21 month:10 pages:251-257 https://dx.doi.org/10.1007/s12028-014-0078-5 lizenzpflichtig Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_32 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_95 GBV_ILN_100 GBV_ILN_101 GBV_ILN_105 GBV_ILN_110 GBV_ILN_120 GBV_ILN_138 GBV_ILN_150 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_171 GBV_ILN_187 GBV_ILN_213 GBV_ILN_224 GBV_ILN_230 GBV_ILN_250 GBV_ILN_281 GBV_ILN_285 GBV_ILN_293 GBV_ILN_370 GBV_ILN_602 GBV_ILN_636 GBV_ILN_702 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2004 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2007 GBV_ILN_2008 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2026 GBV_ILN_2027 GBV_ILN_2031 GBV_ILN_2034 GBV_ILN_2037 GBV_ILN_2038 GBV_ILN_2039 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2049 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2057 GBV_ILN_2059 GBV_ILN_2061 GBV_ILN_2064 GBV_ILN_2065 GBV_ILN_2068 GBV_ILN_2070 GBV_ILN_2086 GBV_ILN_2088 GBV_ILN_2093 GBV_ILN_2106 GBV_ILN_2107 GBV_ILN_2108 GBV_ILN_2110 GBV_ILN_2111 GBV_ILN_2112 GBV_ILN_2113 GBV_ILN_2116 GBV_ILN_2118 GBV_ILN_2119 GBV_ILN_2122 GBV_ILN_2129 GBV_ILN_2143 GBV_ILN_2144 GBV_ILN_2147 GBV_ILN_2148 GBV_ILN_2152 GBV_ILN_2153 GBV_ILN_2188 GBV_ILN_2190 GBV_ILN_2232 GBV_ILN_2336 GBV_ILN_2446 GBV_ILN_2470 GBV_ILN_2472 GBV_ILN_2507 GBV_ILN_2522 GBV_ILN_2548 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4046 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4242 GBV_ILN_4246 GBV_ILN_4249 GBV_ILN_4251 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4326 GBV_ILN_4333 GBV_ILN_4334 GBV_ILN_4335 GBV_ILN_4336 GBV_ILN_4338 GBV_ILN_4393 GBV_ILN_4700 44.90 ASE AR 22 2014 2 21 10 251-257
language	English
source	Enthalten in Neurocritical care 22(2014), 2 vom: 21. Okt., Seite 251-257 volume:22 year:2014 number:2 day:21 month:10 pages:251-257
sourceStr	Enthalten in Neurocritical care 22(2014), 2 vom: 21. Okt., Seite 251-257 volume:22 year:2014 number:2 day:21 month:10 pages:251-257
format_phy_str_mv	Article
institution	findex.gbv.de
topic_facet	Hepatic encephalopathy Cirrhosis Coma FOUR score Glasgow coma scale
dewey-raw	610
isfreeaccess_bool	false
container_title	Neurocritical care
authorswithroles_txt_mv	Mouri, Sarah @@aut@@ Tripon, Simona @@aut@@ Rudler, Marika @@aut@@ Mallet, Maxime @@aut@@ Mayaux, Julien @@aut@@ Thabut, Dominique @@aut@@ Weiss, Nicolas @@aut@@
publishDateDaySort_date	2014-10-21T00:00:00Z
hierarchy_top_id	478509855
dewey-sort	3610
id	SPR02381117X
language_de	englisch
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The incidence is increasing because of improved cirrhosis prognosis. The most widely used scale used to evaluate HE is the West-Haven (WH) scale, with scores ranging from 0 to 4. This scale is easy to use but not suitable for patients with altered consciousness and is not well known by physicians other than hepatologists who manage these conditions. For deep coma, the validated Glasgow Coma Scale (GCS) has been proposed. A new scale for comatose patients, the Full Outline of UnResponsiveness (FOUR) score, has recently been proposed and widely validated. The scale covers eye and motor responses, brainstem reflexes and breathing patterns and is the most validated coma scale. Objective To assess the diagnostic value of the FOUR score for detecting overt HE (OHE) in cirrhotic patients. Methods We prospectively included all patients admitted for cirrhosis at La Pitié-Salpêtrière Hospital from June 2012 to March 2014. Neurological status was assessed by a senior neurologic intensive care physician in the 24 first hours of ICU admission. The recently described and validated French version of the FOUR score was used. Results We screened 100 cirrhotic patients and included 94 (70 males [75 %], mean age 57 ± 11 years): 29 (31 %) with OHE (WH grades 2–4) and 65 (69 %) with No-OHE (WH grades 0–1). Mean FOUR and GCS scores were lower for OHE than No-OHE patients (p < 0.0001). The FOUR score could distinguish between WH grades 0–1, 2–3 and 4 (p < 0.0001). Furthermore, it could accurately detect and quantify OHE with an area under the c-index of 0.88 ± 0.10. The FOUR score was associated with outcome. 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author	Mouri, Sarah
spellingShingle	Mouri, Sarah ddc 610 bkl 44.90 misc Hepatic encephalopathy misc Cirrhosis misc Coma misc FOUR score misc Glasgow coma scale FOUR Score, a Reliable Score for Assessing Overt Hepatic Encephalopathy in Cirrhotic Patients
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topic_title	610 ASE 44.90 bkl FOUR Score, a Reliable Score for Assessing Overt Hepatic Encephalopathy in Cirrhotic Patients Hepatic encephalopathy (dpeaa)DE-He213 Cirrhosis (dpeaa)DE-He213 Coma (dpeaa)DE-He213 FOUR score (dpeaa)DE-He213 Glasgow coma scale (dpeaa)DE-He213
topic	ddc 610 bkl 44.90 misc Hepatic encephalopathy misc Cirrhosis misc Coma misc FOUR score misc Glasgow coma scale
topic_unstemmed	ddc 610 bkl 44.90 misc Hepatic encephalopathy misc Cirrhosis misc Coma misc FOUR score misc Glasgow coma scale
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title	FOUR Score, a Reliable Score for Assessing Overt Hepatic Encephalopathy in Cirrhotic Patients
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title_full	FOUR Score, a Reliable Score for Assessing Overt Hepatic Encephalopathy in Cirrhotic Patients
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author_browse	Mouri, Sarah Tripon, Simona Rudler, Marika Mallet, Maxime Mayaux, Julien Thabut, Dominique Weiss, Nicolas
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title_sort	four score, a reliable score for assessing overt hepatic encephalopathy in cirrhotic patients
title_auth	FOUR Score, a Reliable Score for Assessing Overt Hepatic Encephalopathy in Cirrhotic Patients
abstract	Background Hepatic encephalopathy (HE) is a frequent complication of cirrhosis and a major public health problem. The incidence is increasing because of improved cirrhosis prognosis. The most widely used scale used to evaluate HE is the West-Haven (WH) scale, with scores ranging from 0 to 4. This scale is easy to use but not suitable for patients with altered consciousness and is not well known by physicians other than hepatologists who manage these conditions. For deep coma, the validated Glasgow Coma Scale (GCS) has been proposed. A new scale for comatose patients, the Full Outline of UnResponsiveness (FOUR) score, has recently been proposed and widely validated. The scale covers eye and motor responses, brainstem reflexes and breathing patterns and is the most validated coma scale. Objective To assess the diagnostic value of the FOUR score for detecting overt HE (OHE) in cirrhotic patients. Methods We prospectively included all patients admitted for cirrhosis at La Pitié-Salpêtrière Hospital from June 2012 to March 2014. Neurological status was assessed by a senior neurologic intensive care physician in the 24 first hours of ICU admission. The recently described and validated French version of the FOUR score was used. Results We screened 100 cirrhotic patients and included 94 (70 males [75 %], mean age 57 ± 11 years): 29 (31 %) with OHE (WH grades 2–4) and 65 (69 %) with No-OHE (WH grades 0–1). Mean FOUR and GCS scores were lower for OHE than No-OHE patients (p < 0.0001). The FOUR score could distinguish between WH grades 0–1, 2–3 and 4 (p < 0.0001). Furthermore, it could accurately detect and quantify OHE with an area under the c-index of 0.88 ± 0.10. The FOUR score was associated with outcome. Conclusion The FOUR score can be used to detect and quantify HE in cirrhotic patients, especially by non-hepatologists who are not familiar with the WH scale.
abstractGer	Background Hepatic encephalopathy (HE) is a frequent complication of cirrhosis and a major public health problem. The incidence is increasing because of improved cirrhosis prognosis. The most widely used scale used to evaluate HE is the West-Haven (WH) scale, with scores ranging from 0 to 4. This scale is easy to use but not suitable for patients with altered consciousness and is not well known by physicians other than hepatologists who manage these conditions. For deep coma, the validated Glasgow Coma Scale (GCS) has been proposed. A new scale for comatose patients, the Full Outline of UnResponsiveness (FOUR) score, has recently been proposed and widely validated. The scale covers eye and motor responses, brainstem reflexes and breathing patterns and is the most validated coma scale. Objective To assess the diagnostic value of the FOUR score for detecting overt HE (OHE) in cirrhotic patients. Methods We prospectively included all patients admitted for cirrhosis at La Pitié-Salpêtrière Hospital from June 2012 to March 2014. Neurological status was assessed by a senior neurologic intensive care physician in the 24 first hours of ICU admission. The recently described and validated French version of the FOUR score was used. Results We screened 100 cirrhotic patients and included 94 (70 males [75 %], mean age 57 ± 11 years): 29 (31 %) with OHE (WH grades 2–4) and 65 (69 %) with No-OHE (WH grades 0–1). Mean FOUR and GCS scores were lower for OHE than No-OHE patients (p < 0.0001). The FOUR score could distinguish between WH grades 0–1, 2–3 and 4 (p < 0.0001). Furthermore, it could accurately detect and quantify OHE with an area under the c-index of 0.88 ± 0.10. The FOUR score was associated with outcome. Conclusion The FOUR score can be used to detect and quantify HE in cirrhotic patients, especially by non-hepatologists who are not familiar with the WH scale.
abstract_unstemmed	Background Hepatic encephalopathy (HE) is a frequent complication of cirrhosis and a major public health problem. The incidence is increasing because of improved cirrhosis prognosis. The most widely used scale used to evaluate HE is the West-Haven (WH) scale, with scores ranging from 0 to 4. This scale is easy to use but not suitable for patients with altered consciousness and is not well known by physicians other than hepatologists who manage these conditions. For deep coma, the validated Glasgow Coma Scale (GCS) has been proposed. A new scale for comatose patients, the Full Outline of UnResponsiveness (FOUR) score, has recently been proposed and widely validated. The scale covers eye and motor responses, brainstem reflexes and breathing patterns and is the most validated coma scale. Objective To assess the diagnostic value of the FOUR score for detecting overt HE (OHE) in cirrhotic patients. Methods We prospectively included all patients admitted for cirrhosis at La Pitié-Salpêtrière Hospital from June 2012 to March 2014. Neurological status was assessed by a senior neurologic intensive care physician in the 24 first hours of ICU admission. The recently described and validated French version of the FOUR score was used. Results We screened 100 cirrhotic patients and included 94 (70 males [75 %], mean age 57 ± 11 years): 29 (31 %) with OHE (WH grades 2–4) and 65 (69 %) with No-OHE (WH grades 0–1). Mean FOUR and GCS scores were lower for OHE than No-OHE patients (p < 0.0001). The FOUR score could distinguish between WH grades 0–1, 2–3 and 4 (p < 0.0001). Furthermore, it could accurately detect and quantify OHE with an area under the c-index of 0.88 ± 0.10. The FOUR score was associated with outcome. Conclusion The FOUR score can be used to detect and quantify HE in cirrhotic patients, especially by non-hepatologists who are not familiar with the WH scale.
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container_issue	2
title_short	FOUR Score, a Reliable Score for Assessing Overt Hepatic Encephalopathy in Cirrhotic Patients
url	https://dx.doi.org/10.1007/s12028-014-0078-5
remote_bool	true
author2	Tripon, Simona Rudler, Marika Mallet, Maxime Mayaux, Julien Thabut, Dominique Weiss, Nicolas
author2Str	Tripon, Simona Rudler, Marika Mallet, Maxime Mayaux, Julien Thabut, Dominique Weiss, Nicolas
ppnlink	478509855
mediatype_str_mv	c
isOA_txt	false
hochschulschrift_bool	false
doi_str	10.1007/s12028-014-0078-5
up_date	2024-07-03T21:32:32.038Z
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The incidence is increasing because of improved cirrhosis prognosis. The most widely used scale used to evaluate HE is the West-Haven (WH) scale, with scores ranging from 0 to 4. This scale is easy to use but not suitable for patients with altered consciousness and is not well known by physicians other than hepatologists who manage these conditions. For deep coma, the validated Glasgow Coma Scale (GCS) has been proposed. A new scale for comatose patients, the Full Outline of UnResponsiveness (FOUR) score, has recently been proposed and widely validated. The scale covers eye and motor responses, brainstem reflexes and breathing patterns and is the most validated coma scale. Objective To assess the diagnostic value of the FOUR score for detecting overt HE (OHE) in cirrhotic patients. Methods We prospectively included all patients admitted for cirrhosis at La Pitié-Salpêtrière Hospital from June 2012 to March 2014. Neurological status was assessed by a senior neurologic intensive care physician in the 24 first hours of ICU admission. The recently described and validated French version of the FOUR score was used. Results We screened 100 cirrhotic patients and included 94 (70 males [75 %], mean age 57 ± 11 years): 29 (31 %) with OHE (WH grades 2–4) and 65 (69 %) with No-OHE (WH grades 0–1). Mean FOUR and GCS scores were lower for OHE than No-OHE patients (p < 0.0001). The FOUR score could distinguish between WH grades 0–1, 2–3 and 4 (p < 0.0001). Furthermore, it could accurately detect and quantify OHE with an area under the c-index of 0.88 ± 0.10. The FOUR score was associated with outcome. 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