New Prediction Models of Functional Outcome in Acute Intracerebral Hemorrhage: The dICH Score and uICH Score
Objectives: The original intracerebral hemorrhage (oICH) score is the severity score most commonly used in clinical intracerebral hemorrhage (ICH) research but may be influenced by hematoma expansion or intraventricular hemorrhage (IVH) growth in acute ICH. Here, we aimed to develop new clinical sco...
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Frontiers Media S.A.
2021-05-01
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Series: | Frontiers in Neurology |
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Online Access: | https://www.frontiersin.org/articles/10.3389/fneur.2021.655800/full |
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Article |
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DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Wen-Song Yang Wen-Song Yang Yi-Qing Shen Yi-Qing Shen Xiao Wei Li-Bo Zhao Li-Bo Zhao Qing-Jun Liu Qing-Jun Liu Xiong-Fei Xie Zhi-Wei Zhang Lan Deng Xin-Ni Lv Shu-Qiang Zhang Xin-Hui Li Xin-Hui Li Qi Li Qi Li Qi Li Peng Xie Peng Xie Peng Xie |
spellingShingle |
Wen-Song Yang Wen-Song Yang Yi-Qing Shen Yi-Qing Shen Xiao Wei Li-Bo Zhao Li-Bo Zhao Qing-Jun Liu Qing-Jun Liu Xiong-Fei Xie Zhi-Wei Zhang Lan Deng Xin-Ni Lv Shu-Qiang Zhang Xin-Hui Li Xin-Hui Li Qi Li Qi Li Qi Li Peng Xie Peng Xie Peng Xie New Prediction Models of Functional Outcome in Acute Intracerebral Hemorrhage: The dICH Score and uICH Score Frontiers in Neurology intracerebral hemorrhage ICH score hematoma expansion outcome NCCT marker computed tomography |
author_facet |
Wen-Song Yang Wen-Song Yang Yi-Qing Shen Yi-Qing Shen Xiao Wei Li-Bo Zhao Li-Bo Zhao Qing-Jun Liu Qing-Jun Liu Xiong-Fei Xie Zhi-Wei Zhang Lan Deng Xin-Ni Lv Shu-Qiang Zhang Xin-Hui Li Xin-Hui Li Qi Li Qi Li Qi Li Peng Xie Peng Xie Peng Xie |
author_sort |
Wen-Song Yang |
title |
New Prediction Models of Functional Outcome in Acute Intracerebral Hemorrhage: The dICH Score and uICH Score |
title_short |
New Prediction Models of Functional Outcome in Acute Intracerebral Hemorrhage: The dICH Score and uICH Score |
title_full |
New Prediction Models of Functional Outcome in Acute Intracerebral Hemorrhage: The dICH Score and uICH Score |
title_fullStr |
New Prediction Models of Functional Outcome in Acute Intracerebral Hemorrhage: The dICH Score and uICH Score |
title_full_unstemmed |
New Prediction Models of Functional Outcome in Acute Intracerebral Hemorrhage: The dICH Score and uICH Score |
title_sort |
new prediction models of functional outcome in acute intracerebral hemorrhage: the dich score and uich score |
publisher |
Frontiers Media S.A. |
series |
Frontiers in Neurology |
issn |
1664-2295 |
publishDate |
2021-05-01 |
description |
Objectives: The original intracerebral hemorrhage (oICH) score is the severity score most commonly used in clinical intracerebral hemorrhage (ICH) research but may be influenced by hematoma expansion or intraventricular hemorrhage (IVH) growth in acute ICH. Here, we aimed to develop new clinical scores to improve the prediction of functional outcomes in patients with ICH.Methods: Patients admitted to the First Affiliated Hospital of Chongqing Medical University with primary ICH were prospectively enrolled in this study. Hematoma volume was measured using a semiautomated, computer-assisted technique. The dynamic ICH (dICH) score was developed by incorporating hematoma expansion and IVH growth into the oICH score. The ultra-early ICH (uICH) score was developed by adding the independent non-contrast CT markers to the oICH score. Receiver operating characteristic curve analysis was used to compare performance among the oICH score, dICH score, and uICH score.Results: This study included 76 patients (23.3%) with hematoma expansion and 61 patients (18.7%) with IVH growth. Of 31 patients with two or more non-contrast computed tomography markers, 61.3% died, and 96.8% had poor outcomes at 90 days. After adjustment for potential confounding variables, we found that age, baseline Glasgow Coma Scale score, presence of IVH on initial CT, baseline ICH volume, infratentorial hemorrhage, hematoma expansion, IVH growth, blend sign, black hole sign, and island sign could independently predict poor outcomes in multivariate analysis. In comparison with the oICH score, the dICH score and uICH score exhibited better performance in the prediction of poor functional outcomes.Conclusions: The dICH score and uICH score were useful clinical assessment tools that could be used for risk stratification concerning functional outcomes and provide guidance in clinical decision-making in acute ICH. |
topic |
intracerebral hemorrhage ICH score hematoma expansion outcome NCCT marker computed tomography |
url |
https://www.frontiersin.org/articles/10.3389/fneur.2021.655800/full |
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doaj-63d2ef6f4c1142baa767fd6546e0b3be2021-05-05T05:22:59ZengFrontiers Media S.A.Frontiers in Neurology1664-22952021-05-011210.3389/fneur.2021.655800655800New Prediction Models of Functional Outcome in Acute Intracerebral Hemorrhage: The dICH Score and uICH ScoreWen-Song Yang0Wen-Song Yang1Yi-Qing Shen2Yi-Qing Shen3Xiao Wei4Li-Bo Zhao5Li-Bo Zhao6Qing-Jun Liu7Qing-Jun Liu8Xiong-Fei Xie9Zhi-Wei Zhang10Lan Deng11Xin-Ni Lv12Shu-Qiang Zhang13Xin-Hui Li14Xin-Hui Li15Qi Li16Qi Li17Qi Li18Peng Xie19Peng Xie20Peng Xie21Department of Neurology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, ChinaNational Health Commission Key Laboratory of Diagnosis and Treatment on Brain Functional Diseases, The First Affiliated Hospital of Chongqing Medical University, Chongqing, ChinaDepartment of Neurology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, ChinaNational Health Commission Key Laboratory of Diagnosis and Treatment on Brain Functional Diseases, The First Affiliated Hospital of Chongqing Medical University, Chongqing, ChinaDepartment of Traditional Chinese Medicine, Chongqing Medical and Pharmaceutical College, Chongqing, ChinaDepartment of Neurology, Yongchuan Hospital of Chongqing Medical University, Chongqing, ChinaChongqing Key Laboratory of Cerebrovascular Disease Research, Yongchuan Hospital of Chongqing Medical University, Chongqing, ChinaDepartment of Neurology, Yongchuan Hospital of Chongqing Medical University, Chongqing, ChinaChongqing Key Laboratory of Cerebrovascular Disease Research, Yongchuan Hospital of Chongqing Medical University, Chongqing, ChinaDepartment of Radiology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, ChinaDepartment of Radiology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, ChinaDepartment of Neurology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, ChinaDepartment of Neurology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, ChinaDepartment of Neurology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, ChinaDepartment of Neurology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, ChinaNational Health Commission Key Laboratory of Diagnosis and Treatment on Brain Functional Diseases, The First Affiliated Hospital of Chongqing Medical University, Chongqing, ChinaDepartment of Neurology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, ChinaNational Health Commission Key Laboratory of Diagnosis and Treatment on Brain Functional Diseases, The First Affiliated Hospital of Chongqing Medical University, Chongqing, ChinaChongqing Key Laboratory of Cerebrovascular Disease Research, Yongchuan Hospital of Chongqing Medical University, Chongqing, ChinaDepartment of Neurology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, ChinaNational Health Commission Key Laboratory of Diagnosis and Treatment on Brain Functional Diseases, The First Affiliated Hospital of Chongqing Medical University, Chongqing, ChinaChongqing Key Laboratory of Cerebrovascular Disease Research, Yongchuan Hospital of Chongqing Medical University, Chongqing, ChinaObjectives: The original intracerebral hemorrhage (oICH) score is the severity score most commonly used in clinical intracerebral hemorrhage (ICH) research but may be influenced by hematoma expansion or intraventricular hemorrhage (IVH) growth in acute ICH. Here, we aimed to develop new clinical scores to improve the prediction of functional outcomes in patients with ICH.Methods: Patients admitted to the First Affiliated Hospital of Chongqing Medical University with primary ICH were prospectively enrolled in this study. Hematoma volume was measured using a semiautomated, computer-assisted technique. The dynamic ICH (dICH) score was developed by incorporating hematoma expansion and IVH growth into the oICH score. The ultra-early ICH (uICH) score was developed by adding the independent non-contrast CT markers to the oICH score. Receiver operating characteristic curve analysis was used to compare performance among the oICH score, dICH score, and uICH score.Results: This study included 76 patients (23.3%) with hematoma expansion and 61 patients (18.7%) with IVH growth. Of 31 patients with two or more non-contrast computed tomography markers, 61.3% died, and 96.8% had poor outcomes at 90 days. After adjustment for potential confounding variables, we found that age, baseline Glasgow Coma Scale score, presence of IVH on initial CT, baseline ICH volume, infratentorial hemorrhage, hematoma expansion, IVH growth, blend sign, black hole sign, and island sign could independently predict poor outcomes in multivariate analysis. In comparison with the oICH score, the dICH score and uICH score exhibited better performance in the prediction of poor functional outcomes.Conclusions: The dICH score and uICH score were useful clinical assessment tools that could be used for risk stratification concerning functional outcomes and provide guidance in clinical decision-making in acute ICH.https://www.frontiersin.org/articles/10.3389/fneur.2021.655800/fullintracerebral hemorrhageICH scorehematoma expansionoutcomeNCCT markercomputed tomography |