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Developing and Validating Prognostic Scores for Patients with Acute Intracerebral Hemorrhage

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.

Identiferoai:union.ndltd.org:LACETR/oai:collectionscanada.gc.ca:OTU.1807/42874
Date27 November 2013
CreatorsHuynh, Thien
ContributorsLaupacis, Andreas
Source SetsLibrary and Archives Canada ETDs Repository / Centre d'archives des thèses électroniques de Bibliothèque et Archives Canada
Languageen_ca
Detected LanguageEnglish
TypeThesis

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