brainstem and respiration), each of which has a maximal score of 4. In contrast to the GCS, verbal response is not a component of the FOUR score, making it fully applicable in intubated patients.

In studies with slightly larger sample sizes, patients with GCS scores of 3 4 had primarily poor outcomes. Changaris and associates reported that 50 of the 51 patients with GCS scores of 3 4 ...

the GCS score when combined with other clinical variables, the use of specific GCS scores, the individual components of GCS scores, and the GCS score in relation to certain outcome categories.