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学科主题: 临床医学
题名:
Clinical Prediction Algorithm (BRAIN) to Determine Risk of Hematoma Growth in Acute Intracerebral Hemorrhage
作者: Wang, Xia1,2; Arima, Hisatomi1,2; Salman, Rustam Al-Shahi3; Woodward, Mark1,2; Heeley, Emma1,2; Stapf, Christian4,5; Lavados, Pablo M.6,7; Robinson, Thompson8,9; Huang, Yining10; Wang, Jiguang11; Delcourt, Candice1,2; Anderson, Craig S.1,2; INTERACT Investigators
关键词: clinical trial ; intracerebral hemorrhage
刊名: STROKE
发表日期: 2015-02-01
DOI: 10.1161/STROKEAHA.114.006910
卷: 46, 期:2, 页:376-381
收录类别: SCI
文章类型: Article
WOS标题词: Science & Technology
类目[WOS]: Clinical Neurology ; Peripheral Vascular Disease
研究领域[WOS]: Neurosciences & Neurology ; Cardiovascular System & Cardiology
关键词[WOS]: BLOOD-PRESSURE REDUCTION ; CEREBRAL-HEMORRHAGE ; EXPANSION ; MORTALITY ; WARFARIN ; OUTCOMES ; STROKE ; TRIAL
英文摘要:

Background and Purpose-We developed and validated a simple algorithm to predict the risk of hematoma growth in acute spontaneous intracerebral hemorrhage (ICH) to better inform clinicians and researchers in their efforts to improve outcomes for patients.

Methods-We analyzed data from the computed tomography substudies of the pilot and main phases of the Intensive Blood Pressure Reduction in Acute Cerebral Hemorrhage Trials (INTERACT1 and 2, respectively). The study group was divided into a derivation cohort (INTERACT2, n=964) and a validation cohort (INTERACT1, n=346). Multivariable logistic regression was used to identify factors associated with clinically significant (>= 6 mL) increase in hematoma volume at 24 hours after symptom onset. A parsimonious risk score was developed on the basis of regression coefficients derived from the logistic model.

Results-A 24-point BRAIN score was derived from INTERACT2 (C-statistic, 0.73) based on baseline ICH volume (mL per score, <= 10=0, 10-20=5, >20=7), recurrent ICH (yes=4), anticoagulation with warfarin at symptom onset (yes=6), intraventricular extension (yes=2), and number of hours to baseline computed tomography from symptom onset (<= 1=5, 1-2=4, 2-3=3, 3-4=2, 4-5=1, >5=0) predicted the probability of ICH growth (ranging from 3.4% for 0 point to 85.8% for 24 points) with good discrimination (C-statistic, 0.73) and calibration (Hosmer-Lemeshow P=0.82) in INTERACT1.

Conclusions-The simple BRAIN score predicts the probability of hematoma growth in ICH. This could be used to improve risk stratification for research and clinical practice.

语种: 英语
所属项目编号: 358395 ; 571281 ; 512402 ; 1004170
项目资助者: National Health and Medical Research Council (NHMRC) of Australia ; NHMRC of Australia
WOS记录号: WOS:000348437800027
Citation statistics:
内容类型: 期刊论文
URI标识: http://ir.bjmu.edu.cn/handle/400002259/64489
Appears in Collections:北京大学第一临床医学院_神经内科_期刊论文

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作者单位: 1.Univ Sydney, George Inst Global Hlth, Sydney, NSW 2006, Australia
2.Royal Prince Alfred Hosp, Sydney, NSW, Australia
3.Univ Edinburgh, Ctr Clin Brain Sci, Div Clin Neurosci, Edinburgh, Midlothian, Scotland
4.Hop Lariboisiere, APHP, Dept Neurol, F-75475 Paris, France
5.Univ Paris Diderot, Sorbonne Paris Cite, DHU NeuroVasc Paris Sorbonne, Paris, France
6.Univ Desarrollo, Serv Neurol, Dept Med Clin Alemana, Santiago, Chile
7.Univ Chile, Santiago, Chile
8.Univ Leicester, Dept Cardiovasc Sci, Leicester, Leics, England
9.Univ Leicester, NIHR Biomed Res Unit Cardiovasc Dis, Leicester, Leics, England
10.Peking Univ, Hosp 1, Dept Neurol, Beijing 100871, Peoples R China
11.Shanghai Jiao Tong Univ, Rui Jin Hosp, Shanghai Inst Hypertens, Shanghai 200030, Peoples R China

Recommended Citation:
Wang, Xia,Arima, Hisatomi,Salman, Rustam Al-Shahi,et al. Clinical Prediction Algorithm (BRAIN) to Determine Risk of Hematoma Growth in Acute Intracerebral Hemorrhage[J]. STROKE,2015,46(2):376-381.
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