• N Weiss, G Mutlu, F Essardy, C Nacabal, C Sauves, C Bally, M Houbert, C Lecorre, V Germack, S Demeret, C Pierrot-Deseilligny, and F Bolgert.
• hôpital de la Pitié-Salpêtrière, Paris, France.
• Rev Neurol France. 2009 Oct 1;165(10):796-802.

BackgroundComatose state is a major cause for admission to the intensive care unit. The most commonly used assessment score is the Glasgow coma scale (GCS). Although widely accepted, this score has several limitations. Recently, the full outline of unresponsiveness score (FOUR) has been validated and tested as reliable as the GCS.MethodsWe translated this score in French and tested its reliability in a neurological critical care unit. This study included eight critical care patients and eight intensive care patients. The patients were successively evaluated by two neurologists, four experienced nurses and five inexperienced nurses; a total of 176 evaluations were performed. The weighted kappa (kappa(W)) was used to determine the reliability of the evaluation for both the FOUR score and the GCS.ResultsThe mean age of the patients was 62 years. The interobserver reliability of the French version of the FOUR score was high (kappa(W)=0.86; IC 95%: 0.83-0.89) comparable to that of the GCS (kappa(W)=0.85; IC 95%: 0.82-0.88).ConclusionThe French version of the FOUR score has an excellent interobserver reliability. This score is easy to perform and well accepted, only requiring simple and short training.

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