Czorlich Patrick, Mende Klaus C, Vettorazzi Eik, Regelsberger Jan, Westphal Manfred, Schmidt Nils O
Department of Neurosurgery, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany.
Department of Medical Biometry and Epidemiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Acta Neurochir (Wien). 2015 Nov;157(11):1867-72; discussion 1872. doi: 10.1007/s00701-015-2583-5. Epub 2015 Sep 16.
Intraventricular hemorrhage (IVH) in patients suffering from aneurysmal subarachnoid hemorrhage (aSAH) is a known negative predictor. Scoring systems like Fisher, Le Roux, and original Graeb score (oGS) are established to quantify the volume of IVH. The aim of this study was to evaluate the validity of the recently introduced modified Graeb score (mGS) in patients with aSAH.
A retrospective analysis of the validity of the oGS and mGS in 257 aSAH patients was performed to assess and compare the predictive value of hospital mortality, development of CHC, and early functional outcome.
In univariate analysis, an increase in either the oGS or mGS was associated with a higher risk for hospital mortality, development of CHC, and poor early functional outcome. The correlation of the oGS and mGS was excellent using Pearson's product-moment (r = 0.918; p < 0.001). The predictive value of the oGS was superior to the predictive value of the mGS using receiver operating characteristics and corresponding area under the curve value as there was no statistical significant differences between the scores.
Our study confirms the validity of the recently introduced mGS to quantify the volume of IVH and extends its value in aSAH. However, the mGS offers no additional predictive value for hospital mortality, development of CHC, and poor early functional outcome in patients with aSAH patients compared to the less complex oGS.
动脉瘤性蛛网膜下腔出血(aSAH)患者的脑室内出血(IVH)是一个已知的不良预测指标。像Fisher、Le Roux和原始Graeb评分(oGS)等评分系统已被确立用于量化IVH的体积。本研究的目的是评估最近引入的改良Graeb评分(mGS)在aSAH患者中的有效性。
对257例aSAH患者的oGS和mGS的有效性进行回顾性分析,以评估和比较医院死亡率、脑积水(CHC)的发生以及早期功能结局的预测价值。
在单因素分析中,oGS或mGS的增加与医院死亡率升高、CHC的发生以及不良的早期功能结局风险增加相关。使用Pearson积矩相关分析,oGS和mGS的相关性极佳(r = 0.918;p < 0.001)。使用受试者工作特征曲线及相应的曲线下面积值,oGS的预测价值优于mGS,因为这两个评分之间没有统计学显著差异。
我们的研究证实了最近引入的mGS在量化IVH体积方面的有效性,并扩展了其在aSAH中的价值。然而,与不太复杂的oGS相比,mGS在预测aSAH患者的医院死亡率、CHC的发生以及不良的早期功能结局方面没有额外的预测价值。