Hematoma Shape, Hematoma Size, Glasgow Coma Scale Score and ICH Score: Which Predicts the 30-Day Mortality Better for Intracerebral HematomaReport as inadecuate




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Purpose

To investigate the performance of hematoma shape, hematoma size, Glasgow coma scale GCS score, and intracerebral hematoma ICH score in predicting the 30-day mortality for ICH patients. To examine the influence of the estimation error of hematoma size on the prediction of 30-day mortality.

Materials and Methods

This retrospective study, approved by a local institutional review board with written informed consent waived, recruited 106 patients diagnosed as ICH by non-enhanced computed tomography study. The hemorrhagic shape, hematoma size measured by computer-assisted volumetric analysis CAVA and estimated by ABC-2 formula, ICH score and GCS score was examined. The predicting performance of 30-day mortality of the aforementioned variables was evaluated. Statistical analysis was performed using Kolmogorov-Smirnov tests, paired t test, nonparametric test, linear regression analysis, and binary logistic regression. The receiver operating characteristics curves were plotted and areas under curve AUC were calculated for 30-day mortality. A P value less than 0.05 was considered as statistically significant.

Results

The overall 30-day mortality rate was 15.1% of ICH patients. The hematoma shape, hematoma size, ICH score, and GCS score all significantly predict the 30-day mortality for ICH patients, with an AUC of 0.692 P = 0.0018, 0.715 P = 0.0008 by ABC-2 to 0.738 P = 0.0002 by CAVA, 0.877 P<0.0001 by ABC-2 to 0.882 P<0.0001 by CAVA, and 0.912 P<0.0001, respectively.

Conclusion

Our study shows that hematoma shape, hematoma size, ICH scores and GCS score all significantly predict the 30-day mortality in an increasing order of AUC. The effect of overestimation of hematoma size by ABC-2 formula in predicting the 30-day mortality could be remedied by using ICH score.



Author: Chih-Wei Wang, Yi-Jui Liu, Yi-Hsiung Lee, Dueng-Yuan Hueng, Hueng-Chuen Fan, Fu-Chi Yang, Chun-Jen Hsueh, Hung-Wen Kao, Chun-Jung

Source: http://plos.srce.hr/



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