McNarry and Goldhill compared ACDU Scale (Alert, Confused, Drowsy, Unresponsive) and AVPU scale (Alert, responds to Voice, responds to Pain, Unresponsive) by the American college of surgeons with GCS scale for neurological assessment of critically ill ward patients.
Perioperative neurological assessment can be done by using various methods, including ACDU Scale . The Glasgow ComaScale (GCS) by Teasdale and Jennett is based upon presence of eye opening, best verbal response and best motor response.
This scaling system from 3-15 has good inter-observer reliability and is a powerful predictor of patient survival and neurological outcome.
They suggested that ACDU Scale is a better predictor of deterioration in consciousness level as compared to AVPU scale and is simpler to use in comparison to the GCS scale.
Hence, ACDU Scale should be considered as a screening tool for ward assessments. However, GCS is an objective method of patient assessment and descriptive terms like confusion, stupor, somnolence etc., have not been uniformly defined in the literature, therefore GCS still remains a widely used and validated system to evaluate a neurosurgery patient. Most institutes, are using GCS to evaluate our patients in the perioperative period.