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Predicting long-term outcomes in acute intracerebral haemorrhage using delayed prognostication scores.

作者信息

Lun Ronda, Yogendrakumar Vignan, Ramsay Tim, Shamy Michel, Fahed Robert, Selim Magdy H, Dowlatshahi Dar

机构信息

Department of Medicine, Division of Neurology, Stroke Program, Ottawa Hospital, Ottawa, Ontario, Canada

Clinical Epidemiology Program, School of Epidemiology, Public Health and Preventative Medicine, Ottawa Hospital Research Institute, Ottawa University, Ottawa, Ontario, Canada.

出版信息

Stroke Vasc Neurol. 2021 Dec;6(4):536-541. doi: 10.1136/svn-2020-000656. Epub 2021 Mar 23.


DOI:10.1136/svn-2020-000656
PMID:33758069
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8717768/
Abstract

OBJECTIVE: The concept of the 'self-fulfilling prophecy' is well established in intracerebral haemorrhage (ICH). The ability to improve prognostication and prediction of long-term outcomes during the first days of hospitalisation is important in guiding conversations around goals of care. We previously demonstrated that incorporating delayed imaging into various prognostication scores for ICH improves the predictive accuracy of 90-day mortality. However, delayed prognostication scores have not been used to predict long-term functional outcomes beyond 90 days. DESIGN, SETTING AND PARTICIPANTS: We analysed data from the ICH Deferoxamine trial to see if delaying the use of prognostication scores to 96 hours after ICH onset will improve performance to predict outcomes at 180 days. 276 patients were included. INTERVENTIONS AND MEASUREMENTS: We calculated the original ICH score (oICH), modified-ICH score (MICH), max-ICH score and the FUNC score on presentation (baseline), and on day 4 (delayed). Outcomes assessed were mortality and poor functional outcome in survivors (defined as modified Rankin Scale of 4-5) at 180 days. We generated receiver operating characteristic curves, and measured the area under the curve values (AUC) for mortality and functional outcome. We compared baseline and delayed AUCs with non-parametric methods. RESULTS: At 180 days, 21 of 276 (7.6%) died. Out of the survivors, 54 of 255 had poor functional outcome (21.2%). The oICH, MICH and max-ICH performed significantly better at predicting 180-day mortality when calculated 4 days later compared with their baseline equivalents ((0.74 vs 0.83, p=0.005), (0.73 vs 0.80, p=0.036), (0.74 vs 0.83, p=0.008), respectively). The delayed calculation of these scores did not significantly improve our accuracy for predicting poor functional outcomes. CONCLUSION: Delaying the calculation of prognostication scores in acute ICH until day 4 improved prediction of 6-month mortality but not functional outcomes. TRIAL REGISTRATION NUMBER: ClinicalTrials.gov Registry (NCT02175225).

摘要
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7c33/8717768/c099cad62630/svn-2020-000656f02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7c33/8717768/48964fa5b56f/svn-2020-000656f01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7c33/8717768/c099cad62630/svn-2020-000656f02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7c33/8717768/48964fa5b56f/svn-2020-000656f01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7c33/8717768/c099cad62630/svn-2020-000656f02.jpg

相似文献

[1]
Predicting long-term outcomes in acute intracerebral haemorrhage using delayed prognostication scores.

Stroke Vasc Neurol. 2021-12

[2]
Calculation of Prognostic Scores, Using Delayed Imaging, Outperforms Baseline Assessments in Acute Intracerebral Hemorrhage.

Stroke. 2020-3-10

[3]
Modified ICH score was superior to original ICH score for assessment of 30-day mortality and good outcome of non-traumatic intracerebral hemorrhage.

Clin Neurol Neurosurg. 2021-10

[4]
A Delayed Modified ICH Score Outperforms Baseline Scoring in Acute Intracerebral Hemorrhage.

Neurohospitalist. 2020-7

[5]
Severity assessment in maximally treated ICH patients: The max-ICH score.

Neurology. 2017-7-5

[6]
Predicting mortality in spontaneous intracerebral hemorrhage: can modification to original score improve the prediction?

Stroke. 2006-4

[7]
Predicting outcome after arteriovenous malformation-associated intracerebral hemorrhage with the original ICH score.

World Neurosurg. 2011-12-10

[8]
Multicenter Validation of the max-ICH Score in Intracerebral Hemorrhage.

Ann Neurol. 2021-3

[9]
The max-intracerebral hemorrhage score predicts long-term outcome of intracerebral hemorrhage.

CNS Neurosci Ther. 2018-3-12

[10]
The prediction of 30-day mortality and functional outcome in spontaneous intracerebral hemorrhage with secondary ventricular hemorrhage: a score comparison.

Acta Neurochir Suppl. 2011

引用本文的文献

[1]
Outcome 1 year after ICH: Data from the Tranexamic acid for IntraCerebral Haemorrhage 2 (TICH-2) trial.

Eur Stroke J. 2025-3

[2]
Doctors and nurses subjective predictions of 6-month outcome compared to actual 6-month outcome for adult patients with spontaneous intracerebral haemorrhage (ICH) in neurocritical care: An observational study.

eNeurologicalSci. 2023-12-22

[3]
Plasma SIRT3 as a Biomarker of Severity and Prognosis After Acute Intracerebral Hemorrhage: A Prospective Cohort Study.

Neuropsychiatr Dis Treat. 2022-9-26

本文引用的文献

[1]
A Delayed Modified ICH Score Outperforms Baseline Scoring in Acute Intracerebral Hemorrhage.

Neurohospitalist. 2020-7

[2]
Calculation of Prognostic Scores, Using Delayed Imaging, Outperforms Baseline Assessments in Acute Intracerebral Hemorrhage.

Stroke. 2020-3-10

[3]
Race/ethnicity influences outcomes in young adults with supratentorial intracerebral hemorrhage.

Neurology. 2020-1-22

[4]
Long-term functional outcome following minimally invasive endoscopic intracerebral hemorrhage evacuation.

J Neurointerv Surg. 2020-1-8

[5]
New and expanding ventricular hemorrhage predicts poor outcome in acute intracerebral hemorrhage.

Neurology. 2019-8-1

[6]
Deferoxamine mesylate in patients with intracerebral haemorrhage (i-DEF): a multicentre, randomised, placebo-controlled, double-blind phase 2 trial.

Lancet Neurol. 2019-3-18

[7]
Efficacy and safety of minimally invasive surgery with thrombolysis in intracerebral haemorrhage evacuation (MISTIE III): a randomised, controlled, open-label, blinded endpoint phase 3 trial.

Lancet. 2019-2-7

[8]
Relationship between race and outcome in Asian, Black, and Caucasian patients with spontaneous intracerebral hemorrhage: Data from the Virtual International Stroke Trials Archive and Efficacy of Nitric Oxide in Stroke trial.

Int J Stroke. 2017-11-22

[9]
Factors Considered by Clinicians when Prognosticating Intracerebral Hemorrhage Outcomes.

Neurocrit Care. 2017-12

[10]
Assessment of the interaction of age and sex on 90-day outcome after intracerebral hemorrhage.

Neurology. 2017-9-5

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