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Al-Ajlan FS, Demchuk AM, Aviv RI, Rodriguez-Luna D, Molina C, Silva Y, Dzialowski I, Czlonkowska A A, Boulanger JM, Lum C, Gubitz G, Padma V, Roy J, Kase CS, Hill MD, Dowlatshahi D. Abstract WP372: The Acute ICH Growth Score: Simple and Accurate Predictor of Hematoma Expansion in Patients with Acute Intracerebral Hemorrhage. Stroke 2017. [DOI: 10.1161/str.48.suppl_1.wp372] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background and Purpose:
Acute intracerebral hemorrhage (ICH) hematoma expansion predicts high mortality and morbidity, occurring in a third of patients presenting with this condition. Recent studies correlated ultra-early hematoma growth and hematoma morphologic appearance with ICH expansion. Our purpose was to develop simple and clinically useful score that would predict ICH hematoma expansion accurately.
Methods:
This cohort included patients with primary or anticoagulation-associated ICH patients presenting <6 hours post ictus prospectively enrolled in the PREDICT study. Patients underwent baseline CT, CT angiography and 24-hour CT for hematoma expansion analysis. A risk score model was developed for predicting hematoma expansion (> 6 ml or > 33%). A 7-point acute ICH growth score was based on ultra-early hematoma growth > 5 mL/hour (yes=1), irregular morphology (yes=1), density heterogeneity (yes=1), presence of fluid-blood levels (yes=1), spot sign (yes=1), and use of anticoagulation (yes=2). Discrimination of the expansion score was assessed.
Results:
We retrospectively studied 301 primary or anticoagulation-associated intracerebral hemorrhage patients. The 7-point acute ICH growth score demonstrated good discrimination for hematoma expansion>6 mL or 33% (area under the curve of 0.76). Median and significant HE are shown in the table below (p<0.001).
Conclusions:
In a multicenter prospective study, the ICH expansion score demonstrate good correlation with hematoma expansion, and included recently reported variables such as morphology and ultraearly growth.
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Affiliation(s)
- F S Al-Ajlan
- Ottawa Stroke Program, Univ of Ottawa, Ottawa, Canada
| | - A M Demchuk
- Calgary Stroke Program, Univ of Calgary, Calgary, Canada
| | - R I Aviv
- Med Imaging, Univ of Toronto, Toronto, Canada
| | - D Rodriguez-Luna
- Dept of Neurology, Vall d’Hebron Univ Hosp and Vall d’Hebron Rsch Institute, Barcelona, Spain, barcelona, Spain
| | - C Molina
- Calgary Stroke Program, Dept of Neurology, Vall d’Hebron Univ Hosp, Vall d’Hebron Rsch Institute, Departament de Medicina, Universitat Autonoma de Barcelona, Barcelona, Spain., barcelona, Spain
| | - Y Silva
- Dept of Neurology, Dr Josep Trueta Univ Hosp, Institut d’Investigació Biomèdica Girona, Girona, Spain
| | - I Dzialowski
- Dept of Neurology, Elblandklinikum Meissen Academic Teaching Hosp of the Technische Univ, Dresden, Germany., Dresden, Germany
| | - A Czlonkowska A
- 2nd Dept of Neurology, Institute of Psychiatry and Neurology, Warsaw, Poland Dept of Experimental and Clinical Pharmacology, Med Univ of Warsaw, Warsaw, Poland, Warsaw, Poland
| | - J M Boulanger
- Dept of Medicine, Charles LeMoyne Hosp, Univ of Sherbrooke, Montreal, Canada., Montreal, Canada
| | - C Lum
- Dept of Diagnostic Imaging, Neuroradiology Section, Univ of Ottawa, Ottawa Hosp Rsch Institute, Ottawa, Canada., Ottawa, Canada
| | - G Gubitz
- Dept of Neurology, Dalhousie Univ, Halifax, Canada., Halifax, Canada
| | - V Padma
- Ottawa Stroke Program, Dept of Neurology, All India Institute of Med Sciences,, New Delhi, India
| | - J Roy
- AMRI Neurosciences Cntr, Mukundapurz, ,, Kolkata, Canada
| | - C S Kase
- Dept of Neurology, Boston Med Cntr, Boston, USA., Boston, MA
| | - M D Hill
- Calgary Stroke Program, Dept of Clinical Neurosciences, Hotchkiss Brain Institute,, Calgary, Canada
| | - D Dowlatshahi
- Dept of Medicine (Neurology), Univ of Ottawa and Ottawa Hosp Rsch Institute, Ottawa, Canada., Ottawa, Canada
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