Evaluation of Intracerebral Hemorrhage Functional Outcome Score informativeness for identification of short-term vital outcome in patients with spontaneous supratentorial intracerebral haemorrhage

Authors

  • A. A. Kuznietsov Zaporizhzhіa State Medical University, Ukraine,

DOI:

https://doi.org/10.14739/2310-1210.2018.6.146536

Keywords:

cerebral hemorrhage, X-Ray tomography, mortality, prognosis

Abstract

The main purpose of the study was to conduct the informative value of Intracerebral Hemorrhage Functional Outcome Score (ICH-FOS) assessment for the determination of a short-term vital prognosis in patients with spontaneous supratentorial intracerebral hemorrhage (SSICH).

Materials and methods. A prospective, cohort study was conducted among 191 patients (117 men and 74 women, the mean age was 65.1 ± 0.8 years) with SSICH treated in a conservative manner. This study included clinical assessment (National Institute of Health Stroke Scale, Glasgow Coma Scale), neuroimaging and biochemistry examination. The ICH-FOS was used in order to conduct a complex assessment of the patients’ state severity on admission. The functional outcome of the SSICH acute period was assessed on the 21st day of the disease in accordance with the modified Rankin Scale.

Results. Lethal outcome was noted in 22 patients (11.5 %). The patients with the lethal outcome during the acute period had a higher value of the ICH-FOS (8 (7–10) versus 4 (3–6), P < 0.0001) in the onset of SSICH. Based on a ROC-analysis it was determined that the ICH-FOS >6 is the predictor of the lethal outcome in the acute period of SSICH (Se = 77.3 %; Sp = 81.1 %; AUC ± SE (95 % CI) = 0.86 ± 0.04 (0.80–0.91), P < 0.0001). In the group of patients with the ICH-FOS value >6 (n = 49) lethal outcome was noted in 34.7 % of cases, whereas in the group of patients with the ICH-FOS value ≤6 (n = 142) it was noted only in 3.5 % of cases.

Conclusions. The Intracerebral Hemorrhage Functional Outcome Sсore is a highly informative tool for the determination of a short-term vital prognosis of SSICH acute period outcome. The ICH-FOS >6 is associated with a 9.9-fold increased risk of lethal outcome (RR 95 % CI 3.8–25.3, P < 0.0001).

 

References

Ministerstvo okhorony zdorovia Ukrainy (2014). Unifikovanyi klinichnyi protokol ekstrenoi, pervynnoi, vtorynnoi (spetsializovanoi), tretynnoi (vysokospetsializovanoi) medychnoi dopomohy ta medychnoi reabilitatsii «Hemorahichnyi insult (vnutrishnomozkova hematoma, anevryzmalnyi subarakhnoidalnyi krovovylyv)». Retrieved from http://moz.gov.ua/docfiles/dod275_ukp_2014.pdf [in Ukrainian].

Rogoza, S. V. (2015). Prohnozuvannia perebihu ta naslidku hostroho periodu supratentorialnoho vnutrishnomozkovoho krovovylyvu na tli arterialnoi hipertenzii [Prediction of course and functional outcome of an acute period of hypertensive supratentorial intracerebral hemorrhages against the background of arterial hypertension]. Ukrainskyi nevrolohichnyi zhurnal, 4, 49–54. [in Ukrainian].

Aiyagari, V. (2015). The clinical management of acute intracerebral hemorrhage. Expert Rev Neurother, 15(12), 1421–1432. doi: 10.1586/14737175.2015.1113876.

An, S. J., Kim, T. J., & Yoon, B. W. (2017). Epidemiology, Risk Factors, and Clinical Features of Intracerebral Hemorrhage: An Update. J Stroke, 19(1), 3–10. doi: 10.5853/jos.2016.00864.

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.

Finocchi, C., Balestrino, M., Malfatto, L., Mancardi, G., Serrati, C., & Gandolfo, C. (2018). National Institutes of Health Stroke Scale in patients with primary intracerebral hemorrhage. Neurol Sci. doi: 10.1007/s10072-018-3495-y.

Hung, L. C., Sung, S. F., Hsieh, C. Y., Hu, Y. H., Lin, H. J., Chen, Y. W., et al. (2017) Validation of a novel claims-based stroke severity index in patients with intracerebral hemorrhage. J Epidemiol, 27(1), 24–29. doi: 10.1016/j.je.2016.08.003.

Ji, R., Shen, H., Pan, Y., Wang, P., Liu, G., Wang, Y., et al. (2013). A novel risk score to predict 1-year functional outcome after intracerebral hemorrhage and comparison with existing scores. Crit Care, 17(6), R275. doi: 10.1186/cc13130.

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), 339–48. doi: 10.3988/jcn.2015.11.4.339.

Rahmani, F., Rikhtegar, R, Ala, A., Farkhad-Rasooli, A., & Ebrahimi-Bakhtavar, H. (2018). Predicting 30-day mortality in patients with primary intracerebral hemorrhage: Evaluation of the value of intracerebral hemorrhage and modified new intracerebral hemorrhage scores. Iran J Neurol, 17(1), 47–52.

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(18), 510–517. doi: 10.4103/2152-7806.187493.

Spina, S., Marzorati, C., Vargiolu, A., Magni, F., Riva, M., Rota, M., et al. (2018). Intracerebral hemorrhage in intensive care unit: early prognostication fallacies. A single center retrospective study. Minerva Anestesiol., 84(5), 572–581. doi: 10.23736/S0375-9393.17.12225-X.

Sung, S. F., Hsieh, C. Y., Lin, H. J., Chen, Y. W., Chen, C. H., Kao Yang, Y.H., & Hu, Y. H. (2016). Validity of a stroke severity index for administrative claims data research: a retrospective cohort study. BMC Health Serv Res, 16(1), 509. doi: [10.1186/s12913-016-1769-8].

Yuan, R., Lei, C., Wu, S., Wei, C., Xiong, Y., Xu, M., et al. (2017). Prognostic Significance of Intraventricular Hemorrhage in Vascular Structural Abnormality-Related Intracerebral Hemorrhage. J Stroke Cerebrovasc Dis, 26(3), 636–643. doi: 10.1016/j.jstrokecerebrovasdis.2016.11.012.

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

1.
Kuznietsov AA. Evaluation of Intracerebral Hemorrhage Functional Outcome Score informativeness for identification of short-term vital outcome in patients with spontaneous supratentorial intracerebral haemorrhage. Zaporozhye Medical Journal [Internet]. 2019Feb.1 [cited 2024Dec.24];(6). Available from: http://zmj.zsmu.edu.ua/article/view/146536

Issue

Section

Original research