Abstract W P256: Influence of Withdrawal of Care on Spontaneous Intracerebral Hemorrhage Predictive Scales
Background: Various scoring systems combining different predictors have been developed to more accurately predict the short and long-term outcome after ICH. However, these different scoring systems do not take into account the major influence of the primary cause of mortality in ICH, namely the withdrawal of care (WC). We aim to compare the in-hospital mortality prediction performance after accounting for WC of three widely used scoring systems, the original ICH score (oICH), the ICH Grading scale (ICH-GS), and the simplified ICH score (sICH), in a cohort of ICH patients prior to the development of the aforementioned scales.
Methods: Retrospective observational single center cohort study of adult patients presenting a confirmed diagnosis of ICH. Admission clinical and radiological criteria were obtained through review of medical records and CT at admission. In-hospital mortality was selected as a primary outcome and obtained from the medical records. In the event of death, groups weredivided into: ICH-direct cause of death (cardiac arrest or brain death) andneurological devastation leading to WC. Scoring systems were calculated in each individual patient. Receiver operating characteristic (ROC) analysis was used to assess the ability of each score to predict in-hospital mortality and the maximum Youden Index was identified to denote each score’s optimal predictive cutoff point for each scale. The area under the curve (AUC) between groups was compared by using the Delong et al method. P< 0.05 was set as statistically significant.
Conclusion: Performance of ICH scoring systems accurately predicted in-hospital mortalityeven when WC care is taken into account.
Author Disclosures: S. Ortega Gutierrez: None. M. aranda calleja: None. P. Shah: None. S. Amaro Delgado: None. S. agarwal: None. A. Cunningham: None. R. Sajjad: None. V. Szeder: None. M.T. Torbey: None.
- © 2014 by American Heart Association, Inc.