Department of Neurosurgery, Geisinger, Danville, Pennsylvania, USA.
Geisinger Commonwealth School of Medicine, Scranton, Pennsylvania, USA.
Neurosurgery. 2021 Jul 15;89(2):220-226. doi: 10.1093/neuros/nyab108.
The R2eD AVM scoring system has been recently proposed to predict the risk of hemorrhagic presentation of brain arteriovenous malformations (AVMs).
To perform the first external validation of this R2eD AVM score.
Over a retrospective 10-yr period from 2009 to 2019, 122 patients with brain AVMs fit the inclusion criteria. All components required to calculate the R2eD AVM score had to be available. Patient demographics and score calculations were recorded, as well as the circumstances of their presentation. Multivariable analysis was performed to assess predictors of rupture in the study cohort. Next, area under the receiver operating characteristics and linear-by-linear association were employed to assess the effectiveness of the models.
The mean age of the entire cohort was 45.2 yr, and 8% of patients were nonwhite. A total of 48 (39.3%) patients presented with AVM rupture. In univariable analysis, all 5 categories demonstrated P < .15 association with rupture risk. In multivariable analysis, race (nonwhite), size <3 cm, and exclusive deep venous drainage remained in the model with an area under the curve (AUC) of 0.677. The utilization of the R2eD AVM score yielded an AUC of 0.711.
Even though mitigated by sample size, this study demonstrated acceptable external validity of the R2eD AVM score.
最近提出了 R2eD AVM 评分系统，以预测脑动静脉畸形（AVM）出血表现的风险。
对该 R2eD AVM 评分进行首次外部验证。
在 2009 年至 2019 年的 10 年回顾性研究期间，122 名符合脑 AVM 纳入标准的患者。需要计算 R2eD AVM 评分的所有成分都必须可用。记录患者的人口统计学数据和评分计算结果，以及他们的表现情况。进行多变量分析以评估研究队列中破裂的预测因素。接下来，使用受试者工作特征曲线下面积和线性-线性关联来评估模型的有效性。
整个队列的平均年龄为 45.2 岁，8%的患者为非白人。共有 48 名（39.3%）患者出现 AVM 破裂。在单变量分析中，所有 5 个类别均与破裂风险呈 P < 0.15 关联。在多变量分析中，种族（非白人）、大小 <3 cm 和单纯深部静脉引流在模型中仍然存在，曲线下面积（AUC）为 0.677。R2eD AVM 评分的使用产生了 0.711 的 AUC。
尽管受到样本量的限制，但本研究表明 R2eD AVM 评分具有可接受的外部有效性。
