Clinical prediction rule for neurological sequelae due to acute encephalopathy: a medical community-based validation study in Harima, Japan
| Autor: | Atsushi Nishiyama, Ichiro Morioka, Keisuke Saeki, Tsukasa Tanaka, Masahiro Nishiyama, Kyoko Fujita, Hiroaki Nagase, Azusa Maruyama, Eriko Satake-Inoue, Kazumoto Iijima, Yoshinobu Oyazato, Sadayuki Nukina, Yoshiyuki Uetani, Kanae Takenaka, Kaori Sasaki, Tomoko Kawata, Toru Takumi, Yuichi Takami |
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| Jazyk: | angličtina |
| Rok vydání: | 2017 |
| Předmět: |
Adult
Pediatrics medicine.medical_specialty Multivariate analysis paediatric neurology Hemiplegia Status epilepticus Clinical prediction rule Young Adult 03 medical and health sciences Status Epilepticus 0302 clinical medicine Risk Factors Clinical Decision Rules 030225 pediatrics Positive predicative value medicine Humans Aged Retrospective Studies Brain Diseases Receiver operating characteristic business.industry Research Area under the curve Univariate Paediatrics Retrospective cohort study General Medicine Middle Aged Prognosis Consciousness Disorders epidemiology medicine.symptom business 030217 neurology & neurosurgery |
| Zdroj: | BMJ Open |
| ISSN: | 2044-6055 |
| Popis: | ObjectivesThis study aimed to verify the screening performance of our clinical prediction rule for neurological sequelae due to acute encephalopathy (NSAE-CPR), which previously identified the following three variables as predictive of poor outcomes: (1) refractory status epilepticus; (2) consciousness disturbance and/or hemiplegia at 6 hours from onset and (3) aspartate aminotransferase >90 IU/L within 6 hours of onset.DesignMedical community-based multicentre retrospective cohort study.SettingSix regional hospitals in Harima and one tertiary centre in Kobe, Japan, from 2008 to 2012.ParticipantsWe enrolled a total of 1612 patients aged Primary outcome measuresUnivariate and multivariate analyses were performed to determine the association between each of the three predictor variables and poor AE outcome (Pediatric Cerebral Performance Category score ≥2). Receiver operating characteristic curve (ROC) analysis was also performed to assess the screening performance of the NSAE-CPR.ResultsThe ROC analysis identified at least one of the three predictive variables as an optimal cut-off point, with an area under the curve of 0.915 (95% CI 0.825 to 1.000). The sensitivity, specificity, positive and negative predictive values, positive and negative likelihood ratios and Matthews correlation coefficient were 0.867, 0.954, 0.149, 0.999, 18.704, 0.140 and 0.349, respectively.ConclusionsOur findings indicate that the NSAE-CPR can be used for the screening and identification of patients with poor outcomes due to acute encephalopathy within 6 hours of onset. |
| Databáze: | OpenAIRE |
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