Abstract TP307: Validation of Clinical Prediction Scores in Patients with Primary Intracerebral Hemorrhage
Background and Purpose: Despite advances in medical and surgical management, intracerebral hemorrhage (ICH) continues to be associated with significant mortality and morbidity. Several clinical prediction scores (CPS) have been developed to aid in predicting the clinical outcome based upon initial presentation. This study aimed to validate and compare several of the most recently developed CPS to their traditional counterparts.
Methods: We retrospectively reviewed 501 consecutive patients with ICH who were admitted from the Emergency Department to the a large healthcare system in Dallas, TX between the dates of 6/1/2009 and 6/1/2011. To validated and compared the FUNC, oICH, and ICH-GS CPS the area under the receiver operating characteristic curves were calculated based upon the ability to predict 90 day mortality and good neurologic outcome (GNO) at the time of discharge, defined as a Glasgow Outcome Score of >4. The sensitivity, specificity, and predictive values of the different ICH scores were computed to determine the test’s ability to identify those without GNO.
Results: Of the 501 patients with intracranial hemorrhage, 104 were excluded due to a recognized etiology of their ICH. Complete data was not available in 31 patients. In the resultant 366 patients, the overall mortality at the time of discharge was 114 (31%), 30 (9.5%) of which underwent craniotomy. Of the 252 patients who survived to discharge, 91/252 (36%) survived with GNO. Both the FUNC (AUC: 0.873) and ICH-GS (AUC: 0.888) had similar predictive values and outperformed the oICH (AUC: 0.743) in predicting 90 day mortality (p=<0.001). Similar performance was seen in predicting neurologic outcome at discharge. Table 1. Analysis of ROC Area Under the Curve (AUC) by Outcomes and CPS scores * Significant different from the other two CPS Scores
Conclusion: Overall, the FUNC and ICH-GS CPS appear superior to the oICH in our population.
- © 2012 by American Heart Association, Inc.