Possibilities of clinical neuroimaging assessment scales using for patient severity in the onset of cerebral hemorrhagic supratentorial stroke to predict the outcome of the disease acute period
DOI:
https://doi.org/10.14739/2310-1210.2018.1.121990Keywords:
cerebral hemorrhage, X-Ray tomography, prognosisAbstract
The main purpose of the study was to determine the criteria for the vital and functional prognosis of the cerebral hemorrhagic supratentorial stroke (CHSS) acute period outcome based on the Hemphill Intracerebral Hemorrhage (Hemphill-ICH) Scale and ICH-Grading Scale (ICH-GS) in the onset of the disease.
Materials and methods. A prospective, cohort, complex clinical and paraclinical study was conducted in 124 patients (72 men and 52 women, mean age 64.7 ± 1.1 years) with CHSS. This study included clinical assessment using National Institute of Health Stroke Scale and Glasgow Coma Scale, visualization of cerebral structures and integrated assessment of health state severity using the Hemphill-ICH Scale and ICH-GS. The functional outcome of the acute period was determined by the modified Rankin Scale.
Results. The Hemphill-ICH Scale score ≥2 and ICH-GS score ≥8 are associated with an increased risk of CHSS acute period lethal outcome, at 7.1 [2.8–18.0] (P < 0.01) and 4.4 [2.2–9.3] times (P < 0.01), respectively. The Hemphill-ICH Scale is characterized by a higher informative value for CHSS acute period lethal outcome prediction (AUC = 0.84) in comparison with the ICH-GS (AUC = 0.78, P < 0.05). The ICH-GS is characterized by a higher informative value for the functional prognosis of CHSS acute period outcome (AUC = 0.69) in comparison with the Hemphill-ICH Scale (AUC = 0.61, P < 0.05).
Conclusions. Predictors of CHSS acute period lethal outcome are Hemphill-ICH Scale score ≥ 2 and ICH-GS score ≥8. The Hemphill-ICH Scale score = 0 and ICH-GS score = 5 are the criteria for the favourable functional outcome of CHSS acute period (mRS score ≤3 on the 21st day). The informative value of the Hemphill-ICH Scale and ICH-GS is higher for the vital prognosis than for the functional prognosis of CHSS acute period outcome verification.
References
Ministerstvo okhorony zdorovia Ukrayiny (2014). Unifikovanyi klinichnyi protokol ekstrenoi, pervynnoi, vtorynnoi (spetsializovanoi), tretynnoi (vysokospetsializovanoi) medychnoi dopomohy ta medychnoi reabilitatsii «Hemorahichnyi insult (vnutrishnomozkova hematoma, anevryzmalnyi subarakhnoidalnyi krovovylyv) [Unified clinical protocol of emergency, primary, secondary (specialized), tertiary (highly specialized) medical care and medical rehabilitation "Hemorrhagic stroke (intrahepatic hematoma, aneurysmal subarachnoid hemorrhage)]. Retrieved from http://moz.gov.ua/docfiles/dod275_ukp_2014.pdf
Alerhand, S., & Lay, C. (2017). Spontaneous Intracerebral Hemorrhage. Emerg Med Clin North Am, 35(4), 825–845. doi: 10.1016/j.emc.2017.07.002.
Behrouz, R., Misra, V., Godoy, D. A., Topel, C. H., Masotti, L., Klijn, C. J. M., et al. (2017). Clinical Course and Outcomes of Small Supratentorial Intracerebral Hematomas. J Stroke Cerebrovasc Dis, 26(6), 1216–1221. doi: 10.1016/j.jstrokecerebrovasdis.2017.01.010.
Cai, X., & Rosand, J. (2015). The Evaluation and Management of Adult Intracerebral Hemorrhage. Semin Neurol, 35(6), 638–645. doi: 10.1055/s-0035-1564687.
Chan, S., & Hemphill, J. C. 3rd. (2014). Critical care management of intracerebral hemorrhage. Crit Care Clin, 30(4), 699–717. doi: 10.1016/j.ccc.2014.06.003.
Krishnamurthi, R. V., Moran, A. E., Forouzanfar, M. H., Bennett, D. A., Mensah, G. A., Lawes, C. M., et al. (2014). The global burden of hemorrhagic stroke: a summary of findings from the GBD 2010 study. Glob Heart, 9(1), 101–106. doi: 10.1016/j.gheart.2014.01.003.
Lee, S. H., Park, K. J., Kang, S. H., Jung, Y. G., Park, J. Y., & Park, D. H. (2015). Prognostic Factors of Clinical Outcomes in Patients with Spontaneous Thalamic Hemorrhage. Med Sci Monit, 5(21), 2638–2646. doi: 10.12659/MSM.894132.
LoPresti, M. A., Bruce, S. S., Camacho, E., Kunchala, S., Dubois, B. G., Bruce, E., et al. (2014). Hematoma volume as the major determinant of outcomes after intracerebral hemorrhage. J Neurol Sci, 345(1–2), 3–7. doi: 10.1016/j.jns.2014.06.057.
Mattishent, K., Kwok, C. S., Ashkir, L., Pelpola, K., Myint, P. K., & Loke, Y. K. (2015). Prognostic Tools for Early Mortality in Hemorrhagic Stroke: Systematic Review and Meta-Analysis. J Clin Neurol, 11(4), 339–348. doi: 10.3988/jcn.2015.11.4.339.
Morotti, A., & Goldstein, J. N. (2016). Diagnosis and Management of Acute Intracerebral Hemorrhage. Emerg Med Clin North Am, 34(4), 883–899. doi: 10.1016/j.emc.2016.06.010.
Murthy, S. B., Moradiya, Y., Dawson, J., Lees, K. R., Hanley, D. F., Ziai, W. C. (2015). Perihematomal Edema and Functional Outcomes in Intracerebral Hemorrhage: Influence of Hematoma Volume and Location. Stroke, 46(11), 3088–3092. doi: 10.1161/STROKEAHA.115.010054.
Righy, C., Bozza, M. T., Oliveira, M. F., & Bozza, F. A. (2016). Molecular, Cellular and Clinical Aspects of Intracerebral Hemorrhage: Are the Enemies Within? Curr Neuropharmacol, 14(4), 392–402. doi: 10.2174/1570159X14666151230110058.
Romero, J. M., & Rosand, J. (2016). Hemorrhagic cerebrovascular disease. Handb Clin Neurol, 135, 351–364. doi: 10.1016/B978-0-444-53485-9.00018-0.
Sreekrishnan, A., Dearborn, J. L., Greer, D. M., Shi, F. D., Hwang, D. Y., Leasure, A. C., et al. (2016). Intracerebral Hemorrhage Location and Functional Outcomes of Patients: A Systematic Literature Review and Meta-Analysis. Neurocrit Care, 25(3), 384–391. doi: 10.1007/s12028-016-0276-4.
Weimar, C., & Kleine-Borgmann, J. (2017). Epidemiology, Prognosis and Prevention of Non-Traumatic Intracerebral Hemorrhage. Curr Pharm Des, 23(15), 2193–2196. doi: 10.2174/1381612822666161027152234.
Zweig, M. H., & Campbell, G. (1993). Receiver-operating characteristic (ROC) plots: a fundamental evaluation tool in clinical medicine. Clin Chem, 39(4), 561–577.
Downloads
How to Cite
Issue
Section
License
Authors who publish with this journal agree to the following terms:- Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
- Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
- Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work (See The Effect of Open Access)
