Clinical prediction algorithm (BRAIN) to determine risk of hematoma growth in acute intracerebral hemorrhage
Author
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Wang, Xia
Author
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Arima, Hisatomi
Author
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Al-Shahi Salman, Rustam
Author
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Woodward, Mark
Author
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Heeley, Emma
Author
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Stapf, Christian
Author
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Lavados Germain, Pablo Manuel
Author
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Robinson, Thompson
Author
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Huang, Yining
Author
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Wang, Jiguang
Author
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Delcourt, Candice
Author
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Anderson, Craig S.
Admission date
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2019-03-18T11:52:09Z
Available date
dc.date.available
2019-03-18T11:52:09Z
Publication date
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2015
Cita de ítem
dc.identifier.citation
Stroke. 2015;46:376-381.
Identifier
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15244628
Identifier
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00392499
Identifier
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10.1161/STROKEAHA.114.006910
Identifier
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https://repositorio.uchile.cl/handle/2250/166459
Abstract
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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.
Abstract
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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.
Abstract
dc.description.abstract
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.
Abstract
dc.description.abstract
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.