Charlotte J J van Asch1, Birgitta K Velthuis, Jacoba P Greving, Peter Jan van Laar, Gabriël J E Rinkel, Ale Algra, Catharina J M Klijn. 1. From the Utrecht Stroke Center, Department of Neurology and Neurosurgery, Rudolf Magnus Institute of Neuroscience (C.J.J.v.A., G.J.E.R., A.A., C.J.M.K.), Department of Radiology (B.K.V.), Julius Center for Health Sciences and Primary Care (J.P.G., A.A.), University Medical Center Utrecht, Utrecht, The Netherlands; and Department of Radiology, University Medical Center Groningen, Groningen, The Netherlands (P.J.v.L.).
Abstract
BACKGROUND AND PURPOSE: We aimed to validate externally in a setting outside the United States the secondary intracerebral hemorrhage (ICH) score that was developed to predict the probability of macrovascular causes in patients with nontraumatic ICH. METHODS: Patients with nontraumatic ICH admitted to the University Medical Center Utrecht, the Netherlands, between 2003 and 2011 were included if an angiographic examination, neurosurgical inspection, or pathological examination had been performed. Secondary ICH score performance was assessed by calibration (agreement between predicted and observed outcomes) and discrimination (separation of those with and without macrovascular cause). RESULTS: Forty-eight of 204 patients (23.5%) had a macrovascular cause. The secondary ICH score showed modest calibration (P=0.06) and modest discriminative ability (c-statistic 0.73; 95% confidence interval, 0.65-0.80). Discrimination improved slightly using only noncontrast computed tomography categorization (c-statistic 0.79; 95% confidence interval, 0.72-0.86). CONCLUSIONS: The discriminative ability and calibration of the secondary ICH score are moderate in a university hospital setting outside the United States. Clues on noncontrast computed tomography are the strongest predictor of a macrovascular cause in patients with ICH.
BACKGROUND AND PURPOSE: We aimed to validate externally in a setting outside the United States the secondary intracerebral hemorrhage (ICH) score that was developed to predict the probability of macrovascular causes in patients with nontraumatic ICH. METHODS:Patients with nontraumatic ICH admitted to the University Medical Center Utrecht, the Netherlands, between 2003 and 2011 were included if an angiographic examination, neurosurgical inspection, or pathological examination had been performed. Secondary ICH score performance was assessed by calibration (agreement between predicted and observed outcomes) and discrimination (separation of those with and without macrovascular cause). RESULTS: Forty-eight of 204 patients (23.5%) had a macrovascular cause. The secondary ICH score showed modest calibration (P=0.06) and modest discriminative ability (c-statistic 0.73; 95% confidence interval, 0.65-0.80). Discrimination improved slightly using only noncontrast computed tomography categorization (c-statistic 0.79; 95% confidence interval, 0.72-0.86). CONCLUSIONS: The discriminative ability and calibration of the secondary ICH score are moderate in a university hospital setting outside the United States. Clues on noncontrast computed tomography are the strongest predictor of a macrovascular cause in patients with ICH.
Authors: David J Seiffge; Duncan Wilson; Gareth Ambler; Gargi Banerjee; Isabel Charlotte Hostettler; Henry Houlden; Clare Shakeshaft; Hannah Cohen; Tarek A Yousry; Rustam Al-Shahi Salman; Gregory Lip; Martin M Brown; Keith Muir; H R Jäger; David J Werring Journal: J Neurol Neurosurg Psychiatry Date: 2021-03-19 Impact factor: 10.154
Authors: Charlotte J J van Asch; Birgitta K Velthuis; Gabriël J E Rinkel; Ale Algra; Gérard A P de Kort; Theo D Witkamp; Johanna C M de Ridder; Koen M van Nieuwenhuizen; Frank-Erik de Leeuw; Wouter J Schonewille; Paul L M de Kort; Diederik W Dippel; Theodora W M Raaymakers; Jeannette Hofmeijer; Marieke J H Wermer; Henk Kerkhoff; Korné Jellema; Irene M Bronner; Michel J M Remmers; Henri Paul Bienfait; Ron J G M Witjes; Jacoba P Greving; Catharina J M Klijn Journal: BMJ Date: 2015-11-09