Nomogram Prediction of Short-Term Outcome After Intracerebral Hemorrhage
| Autor: | Hui-Li Kang, Liang Gong, Qiuqiong Cai, Ying Wang |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
Intracerebral hemorrhage
medicine.medical_specialty business.industry Glasgow Coma Scale intracranial pressure International Journal of General Medicine General Medicine Nomogram Logistic regression medicine.disease intracerebral hemorrhage transcranial Doppler Transcranial Doppler nomogram Intraventricular hemorrhage Hematoma Internal medicine medicine Cardiology pulsatility index business neurologic deterioration Intracranial pressure Original Research |
| Zdroj: | International Journal of General Medicine |
| ISSN: | 1178-7074 |
| Popis: | Huili Kang,1,* Qiuqiong Cai,1,* Liang Gong,2 Ying Wang1 1Department of Ultrasound, Shanghai Punan Hospital of Pudong New District, Shanghai, Peopleâs Republic of China; 2Department of Neurosurgery, Shanghai Punan Hospital of Pudong New District, Shanghai, Peopleâs Republic of China*These authors contributed equally to this workCorrespondence: Ying WangDepartment of Ultrasound, Shanghai Punan Hospital of Pudong New District, No. 519, South Pier Road, Pudong New District, Shanghai, 200125, Peopleâs Republic of ChinaTel +86-13918901577Email wy0218wy@aliyun.comBackground: The early symptoms of patients with elevated intracranial pressure (ICP) after intracerebral hemorrhage (ICH) are easily overlooked, which will result in missing the optimal opportunity for clinical intervention. However, it is difficult for ICH patients admitted to the neurology department to receive invasive ICP monitoring, although it is crucial for the early identification of neurologic deterioration (ND).Objective: The aim of this study is to investigate the association between the changes of transcranial Doppler (TCD) variables and ND after onset and establish a nomogram for predicting the short-term outcome of ICH.Methods: A total of 297 patients were recruited and their clinical characteristics and the changes of TCD variables were recorded. The independent prognostic factors for the ND after onset in the ICH patients were screened from multivariate Logistic regression analysis, which were served as inputs for the nomogram construction. Discrimination and calibration validations were performed to assess the performance of the nomogram [concordance index (C-index) for discrimination and HosmerâLemeshow (HL) test for calibration] and the decision curve analysis was applied to assess the clinical suitability.Results: ÎaPI [defined as the change of pulsatility index (PI) between the 1st and 3rd day after onset for affected hemisphere] was independently associated with the ND after onset. Moreover, hematoma volume, presence of intraventricular hemorrhage, and Glasgow coma scale were also the independent prognostic factors of ND. The developed nomogram incorporating ÎaPI showed good discrimination (C-index: 0.916 after 1000 bootstrapping) and calibration (P=0.412, HL test) and yielded net benefits.Conclusion: The nomogram incorporating ÎaPI might be useful in predicting the risk of ND within 14 days after onset, which might help identify patients in the neurology department in need of further care.Keywords: nomogram, intracerebral hemorrhage, transcranial Doppler, intracranial pressure, neurologic deterioration, pulsatility index |
| Databáze: | OpenAIRE |
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