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

Authors

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

DOI:

https://doi.org/10.14739/2310-1210.2019.2.161322

Keywords:

cerebral hemorrhage, prognosis

Abstract

 

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.

References

Kim, J. Y., & Bae, H. J. (2017). Spontaneous Intracerebral Hemorrhage: Management. J Stroke, 19(1), 28–39. doi: 10.5853/jos.2016.01935

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

Poon, M. T., Bell, S. M., & Al-Shahi Salman, R. (2015). Epidemiology of Intracerebral Haemorrhage. Front Neurol Neurosci, 37, 1–12. doi: 10.1159/000437109

Zahuranec, D. B., Fagerlin, A., Sánchez, B. N., Roney, M. E., Thompson, B. B., Fuhrel-Forbis, A., & Morgenstern, L. B. (2016). Variability in physician prognosis and recommendations after intracerebral hemorrhage. Neurology, 86(20), 1864–1871. doi: 10.1212/WNL.0000000000002676

Nisar, T., Alchaki, A., & Hillen, M. (2018). Validation of ICH score in a large urban population. Clin Neurol Neurosurg, 174, 36–39. doi: 10.1016/j.clineuro.2018.09.007

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.

Kuznietsov, A. (2018). 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. Zaporozhye medical journal, 20(1), 47–50. doi: 10.14739/2310-1210.2018.1.121990

Hwang, B. Y., Appelboom, G., Kellner, C. P., Carpenter, A. M., Kellner, M. A., Gigante, P. R., & Sander Connolly E. (2010). Clinical grading scales in intracerebral hemorrhage. Neurocrit Care, 13(1), 141–51. doi: 10.1007/s12028-010-9382-x

Zweig, M. H., & Campbell, G. (1993). Receiver-operating characteristic (ROC) plots: a fundamental evaluation tool in clinical medicine. Clin Chem, 39(4), 561–577.

Gregório, T., Pipa, S., Cavaleiro, P., Atanásio, G., Albuquerque, I., Chaves, P. C., & Azevedo, L. (2018). Prognostic models for intracerebral hemorrhage: systematic review and meta-analysis. BMC Med Res Methodol, 18(1), 145. doi: 10.1186/s12874-018-0613-8

Specogna, A. V., Turin, T. C., Patten, S. B., & Hill, M. D. (2014). Factors associated with early deterioration after spontaneous intracerebral hemorrhage: a systematic review and meta-analysis. PLoS One, 9(5), e96743. doi: 10.1371/journal.pone.0096743

Ye, Z., Ai, X., Hu, X., Fang, F., & You, C. (2017). Clinical features and prognostic factors in patients with intraventricular hemorrhage caused by ruptured arteriovenous malformations. Medicine (Baltimore), 96(45), e8544. doi: 10.1097/MD.0000000000008544

Downloads

How to Cite

1.
Kuznietsov AA. 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. Zaporozhye Medical Journal [Internet]. 2019Apr.2 [cited 2024Nov.13];(2). Available from: http://zmj.zsmu.edu.ua/article/view/161322

Issue

Section

Original research