Validation of the ICH score in patients with spontaneous intracerebral haemorrhage admitted to the intensive care unit in Southern Spain
Metadatos
Afficher la notice complèteAuteur
Rodríguez Fernández, Sonia; Castillo Llorente, Encarnación; Guerrero López, Francisco; Rivera López, Ricardo FranciscoEditorial
BMJ
Date
2018Referencia bibliográfica
Rodríguez-Fernández S, Castillo-Lorente E, Guerrero- Lopez F, et al. Validation of the ICH score in patients with spontaneous intracerebral haemorrhage admitted to the intensive care unit in Southern Spain. BMJ Open 2018;8:e021719.
Résumé
Objective Validation of the intracerebral haemorrhage
(ICH) score in patients with a diagnosis of spontaneous ICH
admitted to the intensive care unit (ICU). Results A total of 336 patients were included. 105 of
whom underwent surgery. Median (IQR) age: 62 (50–70)
years. APACHE-II: 21(15–26) points, GCS: 7 (4–11)
points, ICH score: 2 (2–3) points. 11.1% presented with
bilateral mydriasis on admission (mortality rate=100%).
Intraventricular haemorrhage was observed in 58.9%
of patients. In-hospital mortality was 54.17% while
the APACHE-II predicted mortality was 57.22% with a
standardised mortality ratio (SMR) of 0.95 (95% CI 0.81 to
1.09) and a Hosmer-Lemenshow test value (H) of 3.62 (no
significant statistical difference, n.s.). 30-day mortality was
52.38% compared with the ICH score predicted mortality
of 48.79%, SMR: 1.07 (95% CI 0.91 to 1.23), n.s. Mortality
was higher than predicted at the lowest scores and lower
than predicted in the more severe patients, (H=55.89,
p<0.001), Gruppo Italiano per la Valutazione degli
Interventi in Terapia Intensiva calibration belt (p<0.001).
The area under a receiver operating characteristic (ROC)
curve was 0.74 (95% CI 0.69 to 0.79).
Conclusions ICH score shows an acceptable
discrimination as a tool to predict mortality rates in
patients with spontaneous ICH admitted to the ICU, but its
calibration is suboptimal.