Possibilities of verification of a short-term functional outcome prognosis in the acute period of spontaneous supratentorial intracerebral hemorrhage using modified variants of the Intracerebral Hemorrhage Scale
DOI:
https://doi.org/10.14739/2310-1210.2019.2.161322Keywords:
cerebral hemorrhage, prognosisAbstract
The main purpose of the study was to analyze a diagnostic informative value of modified variants of the Intracerebral Hemorrhage Scale as techniques for detecting adverse functional outcome risk in the acute period of spontaneous supratentorial intracerebral hemorrhage (SSICH).
Materials and methods. A total of 122 conservatively treated patients (mean age was 64.7 ± 1.1 years old) in the acute period of SSICH were enrolled in a prospective study. Clinical and neuroimaging assessment of the patients’ condition severity was conducted on admission to hospital using the ICH Scale and its modified versions (mICH-A, mICH-B). The value >3 in accordance with the modified Rankin Scale on the 21st day of disease was considered as unfavourable functional outcome in SSICH. The ROC analysis was used for the comparative analysis of the scales’ informative value and for the criteria development.
Results. The unfavourable functional outcome in the acute period of SSICH was registered in 50 (41.0 %) patients. These patients at the disease onset had significantly higher values in accordance with the mICH-A Scale (4 (3; 5) versus 2 (1; 3), P < 0.0001) and the mICH-B Scale (3 (2; 4) versus 1 (0; 2), P < 0.0001). It was determined that modified versions of the ICH Scale was more accurate than the original ICH Scale as for a short-term functional prognosis verification (AUCmICH-A 0.81 ± 0.04 (0.73–0.88) versus AUCICH 0.74 ± 0.04, P = 0.0062; AUCmICH-B 0.80 ± 0.04 (0.72–0.87) versus AUCICH 0.74 ± 0.04, P = 0.0104), whereas the mICH-A Scale scores >2 became the predictors of an unfavourable functional outcome in the acute period of disease (sensitivity = 76.0 %; specificity = 69.4 %; RR = 3.6 (3.1–4.1), P ˂ 0.0001) as well as the mICH-B Scale scores >1 (sensitivity = 76.0 %; specificity = 68.1 %; RR = 3.2 (2.8–3.6), P ˂ 0.0001).
Conclusions. Modified versions of the ICH Scale are informative tools for the verification of a short-term functional prognosis in patients with SSICH.
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