BACKGROUND: Initial reports of the FUNC score suggest that it may accurately identify those patients suffering from intracerebral hemorrhage (ICH) with an ultra low chance of functional neurologic recovery. This study's aim is to validate the FUNC score and determine if it accurately identifies the cohort of patients with an ultra low chance of survival with good neurologic recovery. METHODS: Retrospective review of 501 consecutive primary ICH patients admitted from the Emergency Department to a large healthcare system. Performance of the FUNC, ICH-GS, and oICH scores was determined by calculating areas under the receiver-operator-characteristic curves. Patients with a predicted 100 % chance of poor neurologic outcome (PNO) (FUNC <4 and ICH-GS >10) scores were evaluated to determine if DNR impacted 90 day survival or rate of survival with a Glasgow Outcome Score of <3. RESULTS: In 366 cases of primary ICH who presented during the study period, 222(61 %) survived to discharge. Both the FUNC (AUC: 0.873) and ICH-GS (AUC: 0.888) outperformed the oICH (AUC: 0.743) in predicting 90-day mortality (p = <0.001). Of 68 patients with a FUNC score <4, 67 (98.5 %) had PNO at discharge. The presence of DNR was not associated with a significant difference in the rate of PNO at discharge (40/40 = 100 % vs. 27/28 = 96.4 % p = 0.42) or 90-day mortality (40/40 = 100 % vs. 21/28 = 75 %, p = 0.06). CONCLUSION: The FUNC and ICH-GS appear superior to the oICH in predicting outcome in patients with primary ICH. In addition, the FUNC score appears to accurately identify patients with low chance of functional neurologic recovery at discharge.
BACKGROUND: Initial reports of the FUNC score suggest that it may accurately identify those patients suffering from intracerebral hemorrhage (ICH) with an ultra low chance of functional neurologic recovery. This study's aim is to validate the FUNC score and determine if it accurately identifies the cohort of patients with an ultra low chance of survival with good neurologic recovery. METHODS: Retrospective review of 501 consecutive primary ICHpatients admitted from the Emergency Department to a large healthcare system. Performance of the FUNC, ICH-GS, and oICH scores was determined by calculating areas under the receiver-operator-characteristic curves. Patients with a predicted 100 % chance of poor neurologic outcome (PNO) (FUNC <4 and ICH-GS >10) scores were evaluated to determine if DNR impacted 90 day survival or rate of survival with a Glasgow Outcome Score of <3. RESULTS: In 366 cases of primary ICH who presented during the study period, 222(61 %) survived to discharge. Both the FUNC (AUC: 0.873) and ICH-GS (AUC: 0.888) outperformed the oICH (AUC: 0.743) in predicting 90-day mortality (p = <0.001). Of 68 patients with a FUNC score <4, 67 (98.5 %) had PNO at discharge. The presence of DNR was not associated with a significant difference in the rate of PNO at discharge (40/40 = 100 % vs. 27/28 = 96.4 % p = 0.42) or 90-day mortality (40/40 = 100 % vs. 21/28 = 75 %, p = 0.06). CONCLUSION: The FUNC and ICH-GS appear superior to the oICH in predicting outcome in patients with primary ICH. In addition, the FUNC score appears to accurately identify patients with low chance of functional neurologic recovery at discharge.
Authors: M L Flaherty; B Kissela; D Woo; D Kleindorfer; K Alwell; P Sekar; C J Moomaw; M Haverbusch; J P Broderick Journal: Neurology Date: 2007-01-09 Impact factor: 9.910
Authors: Lewis B Morgenstern; J Claude Hemphill; Craig Anderson; Kyra Becker; Joseph P Broderick; E Sander Connolly; Steven M Greenberg; James N Huang; R Loch MacDonald; Steven R Messé; Pamela H Mitchell; Magdy Selim; Rafael J Tamargo Journal: Stroke Date: 2010-07-22 Impact factor: 7.914
Authors: Brian Y Hwang; Geoffrey Appelboom; Christopher P Kellner; Amanda M Carpenter; Michael A Kellner; Paul R Gigante; E Sander Connolly Journal: Neurocrit Care Date: 2010-08 Impact factor: 3.210
Authors: Tiago Gregório; Sara Pipa; Pedro Cavaleiro; Gabriel Atanásio; Inês Albuquerque; Paulo Castro Chaves; Luís Azevedo Journal: Neurocrit Care Date: 2019-04 Impact factor: 3.210
Authors: David Y Hwang; Cameron A Dell; Mary J Sparks; Tiffany D Watson; Carl D Langefeld; Mary E Comeau; Jonathan Rosand; Thomas W K Battey; Sebastian Koch; Mario L Perez; Michael L James; Jessica McFarlin; Jennifer L Osborne; Daniel Woo; Steven J Kittner; Kevin N Sheth Journal: Neurology Date: 2015-12-16 Impact factor: 9.910
Authors: Katja E Wartenberg; David Y Hwang; Karl Georg Haeusler; Susanne Muehlschlegel; Oliver W Sakowitz; Dominik Madžar; Hajo M Hamer; Alejandro A Rabinstein; David M Greer; J Claude Hemphill; Juergen Meixensberger; Panayiotis N Varelas Journal: Neurocrit Care Date: 2019-10 Impact factor: 3.210
Authors: Tiago Gregório; Sara Pipa; Pedro Cavaleiro; Gabriel Atanásio; Inês Albuquerque; Paulo Castro Chaves; Luís Azevedo Journal: BMC Med Res Methodol Date: 2018-11-20 Impact factor: 4.615