A grading scale for surgically treated patients with spontaneous supratentorial intracerebral hemorrhage: the Surgical Swedish ICH Score.

Autor:	Fahlström A; 1Department of Neuroscience, Neurosurgery, Uppsala University, Uppsala University Hospital, Uppsala., Nittby Redebrandt H; 2Department of Clinical Sciences Lund, Neurosurgery, Lund University, Skane University Hospital, Lund., Zeberg H; 3Department of Neuroscience, Karolinska Institutet., Bartek J; 4Department of Medicine and Clinical Neuroscience, Neurosurgery, Karolinska Institutet, Karolinska University Hospital, Stockholm.; 5Department of Neurosurgery, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark., Bartley A; 6Department of Clinical Neuroscience, Neurosurgery, University of Gothenburg, Sahlgrenska Academy, Sahlgrenska University Hospital, Gothenburg., Tobieson L; 7Department of Clinical and Experimental Medicine, Neurosurgery, Linköping University, Linköping University Hospital, Linköping., Erkki M; 8Department of Clinical Neuroscience, Neurosurgery, Umeå University, Umeå University Hospital, Umeå, Sweden; and., Hessington A; 1Department of Neuroscience, Neurosurgery, Uppsala University, Uppsala University Hospital, Uppsala., Troberg E; 2Department of Clinical Sciences Lund, Neurosurgery, Lund University, Skane University Hospital, Lund., Mirza S; 4Department of Medicine and Clinical Neuroscience, Neurosurgery, Karolinska Institutet, Karolinska University Hospital, Stockholm., Tsitsopoulos PP; 1Department of Neuroscience, Neurosurgery, Uppsala University, Uppsala University Hospital, Uppsala., Marklund N; 1Department of Neuroscience, Neurosurgery, Uppsala University, Uppsala University Hospital, Uppsala.; 2Department of Clinical Sciences Lund, Neurosurgery, Lund University, Skane University Hospital, Lund.
Jazyk:	angličtina
Zdroj:	Journal of neurosurgery [J Neurosurg] 2019 Aug 23; Vol. 133 (3), pp. 800-807. Date of Electronic Publication: 2019 Aug 23 (Print Publication: 2020).
DOI:	10.3171/2019.5.JNS19622
Abstrakt:	Objective: The authors aimed to develop the first clinical grading scale for patients with surgically treated spontaneous supratentorial intracerebral hemorrhage (ICH). Methods: A nationwide multicenter study including 401 ICH patients surgically treated by craniotomy and evacuation of a spontaneous supratentorial ICH was conducted between January 1, 2011, and December 31, 2015. All neurosurgical centers in Sweden were included. All medical records and neuroimaging studies were retrospectively reviewed. Independent predictors of 30-day mortality were identified by logistic regression. A risk stratification scale (the Surgical Swedish ICH [SwICH] Score) was developed using weighting of independent predictors based on strength of association. Results: Factors independently associated with 30-day mortality were Glasgow Coma Scale (GCS) score (p = 0.00015), ICH volume ≥ 50 mL (p = 0.031), patient age ≥ 75 years (p = 0.0056), prior myocardial infarction (MI) (p = 0.00081), and type 2 diabetes (p = 0.0093). The Surgical SwICH Score was the sum of individual points assigned as follows: GCS score 15-13 (0 points), 12-5 (1 point), 4-3 (2 points); age ≥ 75 years (1 point); ICH volume ≥ 50 mL (1 point); type 2 diabetes (1 point); prior MI (1 point). Each increase in the Surgical SwICH Score was associated with a progressively increased 30-day mortality (p = 0.0002). No patient with a Surgical SwICH Score of 0 died, whereas the 30-day mortality rates for patients with Surgical SwICH Scores of 1, 2, 3, and 4 were 5%, 12%, 31%, and 58%, respectively. Conclusions: The Surgical SwICH Score is a predictor of 30-day mortality in patients treated surgically for spontaneous supratentorial ICH. External validation is needed to assess the predictive value as well as the generalizability of the Surgical SwICH Score.
Databáze:	MEDLINE
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