Comparison of all 19 published prognostic scores for intracerebral hemorrhage

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Satopaa , J , Mustanoja , S , Meretoja , A , Putaala , J , Kaste , M , Niemela , M , Tatlisumak , T & Strbian , D 2017 , ' Comparison of all 19 published prognostic scores for intracerebral hemorrhage ' , Journal of the Neurological Sciences , vol. 379 , pp. 103-108 . https://doi.org/10.1016/j.jns.2017.05.034

Title: Comparison of all 19 published prognostic scores for intracerebral hemorrhage
Author: Satopaa, Jarno; Mustanoja, Satu; Meretoja, Atte; Putaala, Jukka; Kaste, Markku; Niemela, Mika; Tatlisumak, Turgut; Strbian, Daniel
Contributor: University of Helsinki, Clinicum
University of Helsinki, Department of Neurosciences
University of Helsinki, Department of Neurosciences
University of Helsinki, Neurologian yksikkö
University of Helsinki, Neurologian yksikkö
University of Helsinki, Clinicum
University of Helsinki, Neurologian yksikkö
University of Helsinki, Neurologian yksikkö
Date: 2017-08-15
Language: eng
Number of pages: 6
Belongs to series: Journal of the Neurological Sciences
ISSN: 0022-510X
URI: http://hdl.handle.net/10138/297931
Abstract: Background and aims: We evaluated the accuracy of 19 published prognostic scores to find the best tool for predicting mortality after intracerebral hemorrhage (ICH). Methods: A retrospective single-center analysis of consecutive patients with ICH (n = 1013). After excluding patients with missing data (n = 131), we analyzed 882 patients for 3-month (primary outcome), in-hospital, and 12-month mortality. We analyzed the strength of the individual score components and calculated the c-statistics, Youden index, sensitivity, specificity, negative and positive predictive value (NPV and PPV) for the scores. Finally, we included every score component in a multivariable model to analyze the maximum predictive value of the data elements combined. Results: Observed in-hospital mortality was 23.6%, 3-month mortality was 31.0%, and 12-month mortality was 35.3%. For in-hospital mortality, the National Institutes of Health Stroke Scale (NIHSS) performed equally good as the best score for the other outcomes, the ICH Functional Outcome Score (ICH-FOS). The c-statistics of the scores varied from 0.6293 (95% CI 0.587-0.672) to 0.8802 (0.855-0.906). With all variables from all the scores in a multivariable regression model, the c-statistics did not improve, being 0.89 (0.867-0.913). Using the Youden index cutoff for the ICH-FOS score, the sensitivity (73%), specificity (90%), PPV (76%), and NPV (88%) for the primary outcome were good. Conclusions: A plethora of scores exists to help clinicians estimate the prognosis of an acute ICH patient. The NIHSS can be used to quantify the risk of in-hospital death while the ICH-FOS performed best for the other outcomes. (C) 2017 Elsevier B.V. All rights reserved.
Subject: Cerebral hemorrhage
Stroke
Prognosis
Patient outcome assessment
Mortality
30-DAY MORTALITY
INTRAVENTRICULAR HEMORRHAGE
HEMODIALYSIS-PATIENTS
HOSPITAL MORTALITY
GRADING SCALE
RISK SCORE
ROC CURVES
PREDICTION
VOLUME
POPULATION
3112 Neurosciences
3124 Neurology and psychiatry
3126 Surgery, anesthesiology, intensive care, radiology
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