A grading scale for surgically treated patients with spontaneous supratentorial intracerebral hemorrhage : The Surgical Swedish ICH Score
(2020) In Journal of Neurosurgery 133(3). p.800-807- Abstract
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... (More)
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.
(Less)
- author
- Fahlström, Andreas
; Redebrandt, Henrietta Nittby
LU
; Zeberg, Hugo
; Bartek, Jiri
LU
; Bartley, Andreas
; Tobieson, Lovisa
; Erkki, Maria
; Hessington, Amel
; Troberg, Ebba
LU
; Mirza, Sadia
; Tsitsopoulos, Parmenion P.
and Marklund, Niklas
LU
(Less) - organization
- publishing date
- 2020-09-01
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- Prognostic factors, Spontaneous intracerebral hemorrhage, Stroke, Vascular disorders
- in
- Journal of Neurosurgery
- volume
- 133
- issue
- 3
- pages
- 8 pages
- publisher
- American Association of Neurosurgeons
- external identifiers
-
- pmid:31443074
- scopus:85090326583
- ISSN
- 0022-3085
- DOI
- 10.3171/2019.5.JNS19622
- language
- English
- LU publication?
- yes
- id
- 64c0fa17-b082-4ccc-a99d-f2162604f9f6
- date added to LUP
- 2020-10-01 13:50:00
- date last changed
- 2024-03-05 09:51:14
@article{64c0fa17-b082-4ccc-a99d-f2162604f9f6,
abstract = {{<p>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.</p>}},
author = {{Fahlström, Andreas and Redebrandt, Henrietta Nittby and Zeberg, Hugo and Bartek, Jiri and Bartley, Andreas and Tobieson, Lovisa and Erkki, Maria and Hessington, Amel and Troberg, Ebba and Mirza, Sadia and Tsitsopoulos, Parmenion P. and Marklund, Niklas}},
issn = {{0022-3085}},
keywords = {{Prognostic factors; Spontaneous intracerebral hemorrhage; Stroke; Vascular disorders}},
language = {{eng}},
month = {{09}},
number = {{3}},
pages = {{800--807}},
publisher = {{American Association of Neurosurgeons}},
series = {{Journal of Neurosurgery}},
title = {{A grading scale for surgically treated patients with spontaneous supratentorial intracerebral hemorrhage : The Surgical Swedish ICH Score}},
url = {{http://dx.doi.org/10.3171/2019.5.JNS19622}},
doi = {{10.3171/2019.5.JNS19622}},
volume = {{133}},
year = {{2020}},
}