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- Title
Defining Minor Intracerebral Hemorrhage.
- Authors
Gómez-González, Alejandra; Lazcano, Uxue; Vivanco-Hidalgo, Rosa Maria; Prats-Sánchez, Luis; Guisado-Alonso, Daniel; Delgado-Mederos, Raquel; Camps-Renom, Pol; Martínez Domeño, Alejandro; Cuadrado-Godia, Elisa; Giralt Steinhauer, Eva; Jiménez-Conde, Jordi; Soriano-Tárraga, Carolina; Avellaneda-Gómez, Carla; Rodríguez-Campello, Ana; Martí-Fábregas, Joan; Ois, Angel; Roquer, Jaume
- Abstract
Background and Purpose: The minor stroke concept has not been analyzed in intracerebral hemorrhage (ICH) patients. Our purpose was to determine the optimal cut point on the NIH Stroke Scale (NIHSS) for defining a minor ICH (mICH) in patients with primary ICH. Methods: An ICH was considered minor if associated with a favorable 3-month outcome (modified Rankin Scale score ≤2). For supratentorial ICH, the discovery cohort consisted of 478 patients prospectively admitted at University Hospital del Mar. Association between NIHSS at admission and 3-month outcome was evaluated with area under the curve-receiver operating characteristics (AUC-ROC) and Youden's index to identify the optimal NIHSS cutoff point to define mICH. External validation was performed in a cohort of 242 supratentorial ICH patients from University Hospital Sant Pau. For infratentorial location, patients from both hospitals (n = 85) were analyzed together. Results: The best -NIHSS cutoff point defining supratentorial-mICH was 6 (AUC-ROC = 0.815 [0.774–0.857] in the discovery cohort and AUC-ROC = 0.819 [0.756–0.882] in the external validation cohort). For infratentorial ICH, the best cutoff point was 4 (AUC-ROC = 0.771 [0.664–0.877]). Using these cutoff points, 40.5% of all primary ICH cases were mICH. Of these, 70.2% were living independently at 3-month follow-up (72% for supratentorial ICH and 56.1% for infratentorial ICH) and 6.5% had died (5.3% for supratentorial ICH, and 14.6% for infratentorial ICH). For patients identified as non-mICH, good 3-month outcome was observed in 11.3% of cases; mortality was 51%. Conclusions: The definition of mICH using the NIHSS cutoff point of 6 for supratentorial ICH and 4 for infratentorial ICH is useful to identify good outcome in ICH patients.
- Subjects
NATIONAL Institutes of Health (U.S.); CEREBRAL hemorrhage; NIH Stroke Scale; UNIVERSITY hospitals
- Publication
Cerebrovascular Diseases, 2021, Vol 50, Issue 4, p435
- ISSN
1015-9770
- Publication type
Article
- DOI
10.1159/000515169