ADAM-C score: New risk score for predicting diagnostic yield of transesophageal echocardiography after cerebral ischemia
| Autor: | Philippe Garçon, Charles Sokic, Chrystelle Akret, David Kenizou, Maxime Cournot, Cécile Ricard, Laurent Michel, Marie Melay, Maxime Fayard, Bruno Gallet, Anne Céline Martin, Loic Belle, Clément Charbonnel, Marion Maurin, Rémi Fouche, Patrick Meimoun, Luc Janin-Manificat, François Jourda, Hubert Mann, Jean Louis Georges, Rémy Lubret, Patrick Jourdain, Ulric Vinsonneau, Aurélia Tho-Agostini, Nicolas Dijoux, Maryse Lescure, Guillaume Turlotte, Jean François Rivière, Fernando Pico, Christophe Jego, Tea Toast investigators |
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| Rok vydání: | 2018 |
| Předmět: |
Male
medicine.medical_specialty Heart Diseases Ischemia 030204 cardiovascular system & hematology Brain Ischemia Coronary artery disease 03 medical and health sciences 0302 clinical medicine Predictive Value of Tests Risk Factors Internal medicine Diabetes mellitus Medicine Humans Radiology Nuclear Medicine and imaging Prospective Studies Stroke Aged Framingham Risk Score business.industry Thrombosis Middle Aged medicine.disease Prognosis Stenosis Cardiology Patent foramen ovale Observational study Female Cardiology and Cardiovascular Medicine business human activities 030217 neurology & neurosurgery Echocardiography Transesophageal Follow-Up Studies |
| Zdroj: | Echocardiography (Mount Kisco, N.Y.). 35(8) |
| ISSN: | 1540-8175 |
| Popis: | Background and aim The clinical utility of transesophageal echocardiography (TEE) after brain ischemia (BI) remains a matter of debate. We aimed to evaluate the clinical impact of TEE and to build a score that could help physicians to identify which patients should better benefit from TEE. Methods This prospective, multicenter, observational study included patients over 18 years old, hospitalized for BI. TEE findings were judged discriminant if the results showed important information leading to major changes in the management of patients. Most patients with patent foramen ovale were excluded. Variables independently associated with a discriminant TEE were used to build the prediction model. Results Of the entire population (1479 patients), 255 patients (17%) were classified in the discriminant TEE group. Five parameters were selected as predictors of a discriminant TEE. Accordingly, the ADAM-C score could be calculated as follows: Score = 4 (if age ≥60) + 2 (if diabetes) + 2 (if aortic stenosis from any degrees) + 1 (if multi-territory stroke) + 2 (if history of coronary artery disease). At a threshold lower than 3, the sensitivity, specificity, positive predictive value, and negative predictive value (NPV) of detecting discriminant TEE were 88% (95% CI 85-90), 44% (95% CI 41-47), 21% (95% CI 19-27), and 95% (95% CI 94-97), respectively. Conclusion A simple score based on clinical and transthoracic echocardiographic parameters can help physicians to identify patients who might not benefit from TEE. Indeed, a score lower than 3 has an interesting NPV of 95% (95% CI 94-97). |
| Databáze: | OpenAIRE |
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