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国际多中心验证动静脉畸形相关颅内出血(AVICH)评分。

International multicentre validation of the arteriovenous malformation-related intracerebral haemorrhage (AVICH) score.

机构信息

Department of Neurosurgery, University Hospital Zurich, Zurich, Switzerland.

Department of Neurological Surgery, University of California San Francisco, San Francisco, California, USA.

出版信息

J Neurol Neurosurg Psychiatry. 2018 Nov;89(11):1163-1166. doi: 10.1136/jnnp-2017-316259. Epub 2017 Oct 6.

Abstract

OBJECTIVE

The recently published arteriovenous malformation-related intracerebral haemorrhage (AVICH) score showed better outcome prediction for patients with arteriovenous malformation (AVM)-related intracerebral haemorrhage (ICH) than other AVM or ICH scores. Here we present the results of a multicentre, external validation of the AVICH score.

METHODS

All participating centres (n=11) provided anonymous data on 325 patients to form the Spetzler-Martin (SM) grade, the supplemented SM (sSM) grade, the ICH score and the AVICH score. Modified Rankin score (mRS) at last follow-up (mean 25.6 months) was dichotomized into favourable (mRS 0-2, n=210) and unfavourable (mRS 3-6;n=115). Univariate and AUROC analyses were performed to validate the AVICH score.

RESULTS

Except nidus structure and AVM size, all single parameters forming the SM, sSM, ICH and AVICH score and the scores itself were significantly different between both outcome groups in the univariate analysis. The AVICH score was confirmed to be the highest predictive outcome score with an AUROC of 0.765 compared with 0.705 for the ICH score and 0.682 for the sSM grade.

CONCLUSION

The multicentre-validated AVICH score predicts clinical outcome superior to pre-existing scores. We suggest the routine use of this score for future clinical outcome prediction and in clinical research.

TRIAL REGISTRATION NUMBER

NCT02920645.

摘要

目的

最近发表的动静脉畸形相关脑出血(AVICH)评分与其他动静脉畸形或脑出血评分相比,对动静脉畸形(AVM)相关脑出血(ICH)患者的预后预测能力更强。在此,我们报告了对 AVICH 评分进行的多中心外部验证结果。

方法

所有参与中心(n=11)提供了 325 名患者的匿名数据,以形成斯佩特-马丁(SM)分级、补充 SM(sSM)分级、ICH 评分和 AVICH 评分。最后随访时的改良 Rankin 评分(mRS)(平均 25.6 个月)分为有利(mRS 0-2,n=210)和不利(mRS 3-6;n=115)。进行单变量和 AUROC 分析以验证 AVICH 评分。

结果

除了病灶结构和 AVM 大小外,在单变量分析中,构成 SM、sSM、ICH 和 AVICH 评分的所有单一参数以及评分本身在两组结局之间均有显著差异。AVICH 评分被确认为预测临床结局的最高评分,AUROC 为 0.765,而 ICH 评分为 0.705,sSM 分级为 0.682。

结论

经过多中心验证的 AVICH 评分在预测临床结局方面优于现有的评分。我们建议在未来的临床预后预测和临床研究中常规使用该评分。

试验注册号

NCT02920645。

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