Integral clinical and neuroimaging criteria for the prognosis of spontaneous supratentorial intracerebral hemorrhage acute period outcome
DOI:
https://doi.org/10.14739/2310-1210.2018.02.124820Keywords:
cerebral hemorrhage, X-Ray tomography, prognosisAbstract
The purpose of this study was to develop integrated clinical and neuroimaging criteria for the prediction of spontaneous supratentorial intracerebral hemorrhage (SSICH) acute period outcome.
Materials and methods. Complex clinical and neuroimaging study was conducted in 105 patients (56 men and 49 women, mean age 63.6 ± 1.2 years) with SSICH in acute period of the disease receiving conservative therapy. The examination included computer tomography of the brain and clinical assessment using National Institute of Health Stroke Scale (NIHSS), Glasgow Coma Scale (GCS). The disability level was detected in accordance with the modified Rankine Scale (mRS) on the 21st day of the disease.
Results. Lethal outcome (21.9 %), unfavourable functional outcome in the form of 4–5 points in accordance with the mRS (33.4 %) and favourable functional outcome in the form of ≤3 points in accordance with the aforementioned scale on the 21st day of SSICH (45.7 %) were registered. The mathematical model has been elaborated for the prediction of lethal outcome of SSICH acute period, which takes into account the initial level of neurological deficit in accordance with NIHSS, the lesion volume and septum pellucidum displacement at the onset of the disease (AUC = 0.91 (0.84–0.96), P < 0.01). The mathematical model has been elaborated for the prediction of functional outcome of SSICH acute period, which takes into account the patient’s age, the level of neurological deficit in accordance with NIHSS, the lesion volume at the onset of the disease (AUC = 0.89 (0.80–0.95), P < 0.01).
Conclusions. Integral clinical and neuroimaging predictors of the lethal outcome of SSICH acute period (Se = 91.3 %; Sp = 82.9 %; accuracy of prediction = 85.7 %) and mRS score ≤3 on the 21st day of the disease (Se = 85.4 %; Sp = 82.4 %; accuracy of prediction = 80.5 %) were determined.
References
Aiyagari, V. The clinical management of acute intracerebral hemorrhage. (2015). Expert Rev Neurother, 15(12), 1421–1432. doi: 10.1586/14737175.2015.1113876.
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.
Camacho, E., LoPresti, M. A., Bruce, S., Lin, D., Abraham, M., Appelboom, G., et al. (2015). The role of age in intracerebral hemorrhages. J Clin Neurosci, 22(12), 1867–1870. doi: 10.1016/j.jocn.2015.04.020.
Chen, G., Ping, L., Zhou, S., Liu, W., Liu, L., Zhang, D., et al. (2016). Early prediction of death in acute hypertensive intracerebral hemorrhage. Exp Ther Med, 11(1), 83–88. doi: 10.3892/etm.2015.2892.
Godoy, D. A., Piñero, G. R., Koller, P., Masotti, L., & Di Napoli, M. (2015). Steps to consider in the approach and management of critically ill patient with spontaneous intracerebral hemorrhage. World J Crit Care Med, 4(3), 213–229. doi: 10.5492/wjccm.v4.i3.213.
Heeley, E., Anderson, C. S., Woodward, M., Arima, H., Robinson, T., Stapf, C., et al. (2015). Poor utility of grading scales in acute intracerebral hemorrhage: results from the INTERACT2 trial. Int J Stroke, 10(7), 1101–1107. doi: 10.1111/ijs.12518.
Jolink, W. M., Klijn, C. J., Brouwers, P. J., Kappelle, L. J., & Vaartjes, I. (2015). Time trends in incidence, case fatality, and mortality of intracerebral hemorrhage. Neurology, 85(15), 1318–1324. doi: 10.1212/WNL.0000000000002015.
Ozdinc, S., Unlu, E., Karakaya, Z., Turamanlar, O., Dogan, N., Isler, Y., et al. (2016). Prognostic value of perihematomal edema area at the initial ED presentation in patients with intracranial hematoma. Am J Emerg Med, 34(7), 1241–1246. doi: 10.1016/j.ajem.2016.03.048.
Panchal, H. N., Shah, M. S., & Shah, D. S. (2015). Intracerebral Hemorrhage Score and Volume as an Independent Predictor of Mortality in Primary Intracerebral Hemorrhage Patients. Indian J Surg, 77(Suppl 2), 302–304. doi: 10.1007/s12262-012-0803-2.
Safatli, D. A., Günther, A., Schlattmann, P., Schwarz, F., Kalff, R., & Ewald, C. (2016). Predictors of 30-day mortality in patients with spontaneous primary intracerebral hemorrhage. Surg Neurol Int, 7(Suppl 18), 510–517. doi: 10.4103/2152-7806.187493.
Stein, M., Hamann, G. F., Misselwitz, B., Uhl, E., Kolodziej, M., & Reinges, M. H. (2016). In-Hospital Mortality and Complication Rates in Surgically and Conservatively Treated Patients with Spontaneous Intracerebral Hemorrhage in Central Europe: A Population-Based Study. World Neurosurg, 88, 306–310. doi: 10.1016/j.wneu.2015.11.075.
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