Calculation of Prognostic Scores, Using Delayed Imaging, Outperforms Baseline Assessments in Acute Intracerebral Hemorrhage

Stroke; a Journal of Cerebral Circulation
Ronda LunDar Dowlatshahi

Abstract

Background and Purpose- Patients with intracerebral hemorrhage (ICH) are often subject to rapid deterioration due to hematoma expansion. Current prognostic scores are largely based on the assessment of baseline radiographic characteristics and do not account for subsequent changes. We propose that calculation of prognostic scores using delayed imaging will have better predictive values for long-term mortality compared with baseline assessments. Methods- We analyzed prospectively collected data from the multicenter PREDICT study (Prediction of Hematoma Growth and Outcome in Patients With Intracerebral Hemorrhage Using the CT-Angiography Spot Sign). We calculated the ICH Score, Functional Outcome in Patients With Primary Intracerebral Hemorrhage (FUNC) Score, and modified ICH Score using imaging data at initial presentation and at 24 hours. The primary outcome was mortality at 90 days. We generated receiver operating characteristic curves for all 3 scores, both at baseline and at 24 hours, and assessed predictive accuracy for 90-day mortality with their respective area under the curve. Competing curves were assessed with nonparametric methods. Results- The analysis included 280 patients, with a 90-day mortality rate of 25.4%. All...Continue Reading

References

Apr 3, 2001·Stroke; a Journal of Cerebral Circulation·J C HemphillS C Johnston
Aug 12, 2004·Neurology·R LeiraUNKNOWN Stroke Project, Cerebrovascular Diseases Group of the Spanish Neurological Society
Apr 26, 2006·Neurology·S M DavisUNKNOWN Recombinant Activated Factor VII Intracerebral Hemorrhage Trial Investigators
Jun 17, 2008·Stroke; a Journal of Cerebral Circulation·Natalia S RostJonathan Rosand
Feb 25, 2011·Neurology·D DowlatshahiUNKNOWN VISTA Collaboration
Jul 7, 2017·Neurology·Jochen A SembillJoji B Kuramatsu
Jan 6, 2018·Critical Care Medicine·Vignan YogendrakumarUNKNOWN Prediction of haematoma growth and outcome in patients with intracerebral haemorrhage using the CT-angiography spot sign [PR
Aug 19, 2018·Lancet Neurology·Rustam Al-Shahi SalmanUNKNOWN ICH Growth Individual Patient Data Meta-analysis Collaborators
Aug 3, 2019·Neurology·Vignan YogendrakumarUNKNOWN the PREDICT/Sunnybrook CTA Study Group

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Citations

Mar 25, 2021·Stroke and Vascular Neurology·Ronda LunDar Dowlatshahi
Apr 4, 2021·Journal of Clinical Medicine·Peter B SpornsAndrea Morotti
Apr 6, 2021·European Stroke Journal·Raffaele OrnelloSimona Sacco
May 4, 2021·Neurological Research and Practice·Jens WitschHagen B Huttner

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Software Mentioned

SPSS
SAS
PREDICT

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