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Tytuł:
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The Evaluation of Prognostic Scores in Spontaneous Intracerebral Hemorrhage in an Asian Population: A Retrospective Study.
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Autorzy:
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Lim MJR; Division of Neurosurgery, University Surgical Cluster, National University Hospital, 5 Lower Kent Ridge Rd, Singapore 119074, Singapore; Ministry of Health Holdings, 1 Maritime Square, Singapore 099253, Singapore. Electronic address: .
Neo AYY; Ministry of Health Holdings, 1 Maritime Square, Singapore 099253, Singapore.
Singh GD; Ministry of Health Holdings, 1 Maritime Square, Singapore 099253, Singapore.
Liew YST; Ministry of Health Holdings, 1 Maritime Square, Singapore 099253, Singapore.
Rajendram MF; Ministry of Health Holdings, 1 Maritime Square, Singapore 099253, Singapore.
Tan MWX; Ministry of Health Holdings, 1 Maritime Square, Singapore 099253, Singapore.
Ragupathi T; Ministry of Health Holdings, 1 Maritime Square, Singapore 099253, Singapore.
Lwin S; Division of Neurosurgery, University Surgical Cluster, National University Hospital, 5 Lower Kent Ridge Rd, Singapore 119074, Singapore.
Chou N; Division of Neurosurgery, University Surgical Cluster, National University Hospital, 5 Lower Kent Ridge Rd, Singapore 119074, Singapore.
Sharma VK; Division of Neurology, University Medicine Cluster, National University Hospital, 5 Lower Kent Ridge Rd, Singapore 119074, Singapore.
Yeo TT; Division of Neurosurgery, University Surgical Cluster, National University Hospital, 5 Lower Kent Ridge Rd, Singapore 119074, Singapore.
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Źródło:
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Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association [J Stroke Cerebrovasc Dis] 2020 Dec; Vol. 29 (12), pp. 105360. Date of Electronic Publication: 2020 Oct 15.
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Typ publikacji:
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Comparative Study; Journal Article; Validation Study
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Język:
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English
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Imprint Name(s):
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Publication: Philadelphia, PA : Saunders
Original Publication: New York, NY : Demos Publications, [1991-
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MeSH Terms:
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Clinical Decision Rules*
Cerebral Hemorrhage/*diagnosis
Adult ; Aged ; Aged, 80 and over ; Asian People ; Cerebral Hemorrhage/ethnology ; Cerebral Hemorrhage/mortality ; Cerebral Hemorrhage/therapy ; Clinical Decision-Making ; Disability Evaluation ; Electronic Health Records ; Female ; Humans ; Male ; Middle Aged ; Predictive Value of Tests ; Prognosis ; Recovery of Function ; Reproducibility of Results ; Retrospective Studies ; Risk Assessment ; Risk Factors ; Singapore/epidemiology ; Time Factors
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Contributed Indexing:
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Keywords: Cerebrovascular disease; Intracerebral hemorrhage; Mortality; Patient outcome assessment; Prognosis
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Entry Date(s):
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Date Created: 20201017 Date Completed: 20201208 Latest Revision: 20221207
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Update Code:
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20240105
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DOI:
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10.1016/j.jstrokecerebrovasdis.2020.105360
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PMID:
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33069085
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Objective: Clinical grading scales used for prognostication in spontaneous intracerebral hemorrhage facilitate informed-decision making for resource-intensive interventions. Numerous clinical prognostic scores are available for spontaneous intracerebral hemorrhage. However, these have not been validated well in Asian patients, and the most appropriate scoring system remains debatable. We evaluated the utility of clinical scores in prognosticating 30-day mortality and 90-day functional outcome in patients with spontaneous intracerebral hemorrhage.
Materials and Methods: We conducted a retrospective review of all patients with spontaneous intracerebral hemorrhage admitted to our tertiary center from December 2014 to May 2016. Data on clinical presentation, imaging, and outcomes were extracted from electronic medical records using a standardized form. The data were analyzed for predictors of outcomes. Performance of prognostic scales was compared using receiver-operator characteristic statistics.
Results: A total of 297 patients were included in the study. Mean age was 60.1 (SD 15.2) years and 190 (64.0%) were male. Thirty-two (10.8%) cases died within 30 days and 177 (62.8%) cases had poor functional outcome (modified Rankin scale of 3 or more) at 90 days. Dialysis dependency (OR=33.54, 95%CI=4.21-325.26, p=0.002), Glasgow coma scale (OR=0.76, 95%CI=0.64-0.88, p=0.001), hematoma volume (OR=1.02, 95%CI=1.00-1.04, p=0.027), and surgical evacuation (OR=0.15, 95%CI=0.02-0.66, p=0.024) were independent predictors for 30-day mortality. The original ICH score (0.862) and the ICH-Grading Scale (0.781) had the highest c-statistic for 30-day mortality and 90-day poor functional outcome respectively.
Conclusions: Current prognostic scores performed acceptable-to-good in our patient cohort. Future studies may be useful to investigate the utility of these scores in clinical decision-making.
Competing Interests: Declaration of Competing Interest None.
(Copyright © 2020 Elsevier Inc. All rights reserved.)
