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"[ABSTRAKLatar Belakang. Penilaian derajat kesadaran penting dilakukan pada pasien di Unit Gawat Darurat untuk memperkirakan prognosis. Banyak sistem penilaian dipakai untuk mengevaluasi pasien, masing-masing dengan kelebihan dan kekurangannya. Sistem penilaian yang baru, yaitu Full Outline of Unresponsiveness (FOUR )Score, dapat digunakan menilai derajat kesadaran dan memprediksi prognosis pasien. FOUR Score dapat memberikan data neurologis yang lebih detail dan dapat digunakan pada pasien yang terintubasi. Belum ada penelitian yang menilai validitas FOUR Score sebagai prediktor outcome pada pasien dengan penurunan kesadaran di IGD RSCM sebelumnya.Metode. Penelitian kohort prospektif observasional pada pasien dengan penurunan kesadaran yang dirawat di IGD RSCM. Evaluasi FOUR Score dilakukan terhadap 120 pasien baru yang dirawat di IGD RSCM. Outcome pasien dicatat setelah perawatan 72 jam. Analisis bivariat digunakan untuk menentukan hubungan FOUR Score terhadap outcome. Analisis regresi logistik untuk menentukan hubungan komponen FOUR Score terhadap outcome. Nilai area di bawah kurva (AUC) digunakan untuk sebagai uji dsikriminasi FOUR Score terhadap outcome.Hasil. Terdapat hubungan yang bermakna antara nilai FOUR Score dengan outcome (p <0,001). Komponen respon membuka mata (FOUR-E) dan pola respirasi (FOUR-R) adalah komponen yang mempunyai nilai prediksi terhadap outcome. AUC FOUR Score adalah 0,864 (95% IK 0,784-0,928).Uji kesesuaian antarpenilai antara dokter dan perawat menunjukkan kesesuaian yang sangat baik dengan κ = 0,836 (95% IK 0,786- 0,894), p <0,001.

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ABSTRACTBackground. Asssessment of conciousness is important in patients in emergency room to estimate prognosis. Many scoring systems used to evaluate patients? level of conciousness, each with their advantages and disadvantages Full Outline of Unresponsiveness (FOUR) Score is a new system to assess patients?s level of conciousness and future prognosis. FOUR Score can provide a detailed neurological data and can be used in patients who are intubated. There have never been done a research on validity of FOUR Score as a predictor of outcome in RSCM?s ER before.Method. Observational, prospective cohort study in patients with decreased of conciousness treated in the RSCM?s ER. FOUR Score?s evaluation conducted on 120 new patients. Patient?s outcome was recorded after 72 hours of treatment, and classified as dead or alive. Bivariate analysis conducted to determine the relation between FOUR Score and outcome. Logistic regression analysis was performed to determine the relation between components of the FOUR Score and the outcome, and the value of area under the curve (AUC) of the FOUR Score to outcome was determined to measure discrimination of FOUR Score.Results. There is a significant correlation statistically between the value of the FOUR Score with the outcome (p <0.001). From all the components had been measured, the eye response (FOUR-E) and respiratory pattern (FOUR-R) had predictive value related to the outcome. AUC of the FOUR Score is 0,864 (95% CI 0,784-0,928). Inter-rater agreement between doctor and nurse shows a very good strength of agreement wtith κ = 0,836 (95% CI 0,786- 0,894), p <0,001.Conclusion. FOUR Score can accurately predict the outcome of patients with decreased of consciousness in the RSCM?s ER after 72 hours of treatment.;Background. Asssessment of conciousness is important in patients in emergency room to estimate prognosis. Many scoring systems used to evaluate patients? level of conciousness, each with their advantages and disadvantages Full Outline of Unresponsiveness (FOUR) Score is a new system to assess patients?s level of conciousness and future prognosis. FOUR Score can provide a detailed neurological data and can be used in patients who are intubated. There have never been done a research on validity of FOUR Score as a predictor of outcome in RSCM?s ER before.Method. Observational, prospective cohort study in patients with decreased of conciousness treated in the RSCM?s ER. FOUR Score?s evaluation conducted on 120 new patients. Patient?s outcome was recorded after 72 hours of treatment, and classified as dead or alive. Bivariate analysis conducted to determine the relation between FOUR Score and outcome. Logistic regression analysis was performed to determine the relation between components of the FOUR Score and the outcome, and the value of area under the curve (AUC) of the FOUR Score to outcome was determined to measure discrimination of FOUR Score.Results. There is a significant correlation statistically between the value of the FOUR Score with the outcome (p <0.001). From all the components had been measured, the eye response (FOUR-E) and respiratory pattern (FOUR-R) had predictive value related to the outcome. AUC of the FOUR Score is 0,864 (95% CI 0,784-0,928). Inter-rater agreement between doctor and nurse shows a very good strength of agreement wtith κ = 0,836 (95% CI 0,786- 0,894), p <0,001.Conclusion. FOUR Score can accurately predict the outcome of patients with decreased of consciousness in the RSCM?s ER after 72 hours of treatment., Background. Asssessment of conciousness is important in patients in emergency room to estimate prognosis. Many scoring systems used to evaluate patients? level of conciousness, each with their advantages and disadvantages Full Outline of Unresponsiveness (FOUR) Score is a new system to assess patients?s level of conciousness and future prognosis. FOUR Score can provide a detailed neurological data and can be used in patients who are intubated. There have never been done a research on validity of FOUR Score as a predictor of outcome in RSCM?s ER before.Method. Observational, prospective cohort study in patients with decreased of conciousness treated in the RSCM?s ER. FOUR Score?s evaluation conducted on 120 new patients. Patient?s outcome was recorded after 72 hours of treatment, and classified as dead or alive. Bivariate analysis conducted to determine the relation between FOUR Score and outcome. Logistic regression analysis was performed to determine the relation between components of the FOUR Score and the outcome, and the value of area under the curve (AUC) of the FOUR Score to outcome was determined to measure discrimination of FOUR Score.Results. There is a significant correlation statistically between the value of the FOUR Score with the outcome (p <0.001). From all the components had been measured, the eye response (FOUR-E) and respiratory pattern (FOUR-R) had predictive value related to the outcome. AUC of the FOUR Score is 0,864 (95% CI 0,784-0,928). Inter-rater agreement between doctor and nurse shows a very good strength of agreement wtith κ = 0,836 (95% CI 0,786- 0,894), p <0,001.Conclusion. FOUR Score can accurately predict the outcome of patients with decreased of consciousness in the RSCM?s ER after 72 hours of treatment.]"

"The contents of this book are a selection taken from materials that have been developed during the preparation of continuing education courses (distance learning), whose scientific advisor is the volume editor, Professor Allaria, and that have never previously been published. The topics considered are wide ranging; particular attention is devoted to general topics of importance to the practitioner, but specific controversial issues, such as the role of goal-directed hemodynamic therapy, are also addressed. All of the authors are recognized experts on the subjects they discuss. The book is part of a wider project that aims to provide updated information each year not only in anesthesiology but also in other fields, including cardiology, ophthalmology, and nephrology."

"This book presents to all those who are interested in the history of Anaesthesiology historical details and information on the development of anaesthesiology in Germany and the remarkable growth of our Society. At the founding session of the German Society of Anaesthesia in Munich on 10 April 1953 42 persons had signed the founding documents. Today about 12,000 anaesthetists are members of the German Society of Anaesthesiology and Intensive Care Medicine, making the DGAI the biggest national society within ESA."