Objective: To develop a score for hematoma expansion prediction, identify predictors of outcome, and validated existing prognostic scores in acute intracerebral hemorrhage (ICH).
Methods: Data were obtained from a prospective multicenter ICH cohort. Patients were evaluated with computed tomography (CT) angiography, 24-hour CT, and 3-month outcome. Multivariable regression identified predictors of 24-hour expansion and 3-month outcome and a score was developed for expansion prediction. Existing scores were evaluated in the dataset.
Results: The PREDICT Hematoma Expansion Score predicts 24-hour expansion based on number of spots, stroke severity, time from onset, and coagulopathy (c-statistic: 0.803). Prediction was improved over spot sign presence (p<0.001) and clinical variables alone (p=0.002). Existing scores for hematoma expansion and clinical outcome demonstrated reduced discrimination compared with the original reports.
Conclusion: The PREDICT Hematoma Expansion Score may aid patient selection for future interventions aimed at reducing expansion however external validation is required. Existing scores demonstrated reduced discrimination.
| Identifer | oai:union.ndltd.org:TORONTO/oai:tspace.library.utoronto.ca:1807/42874 |
| Date | 27 November 2013 |
| Creators | Huynh, Thien |
| Contributors | Laupacis, Andreas |
| Source Sets | University of Toronto |
| Language | en_ca |
| Detected Language | English |
| Type | Thesis |
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