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Comparison between the formula 1/2ABC and 2/3Sh in intracerebral parenchyma hemorrhage.
MedLine Citation:
PMID:  23540406     Owner:  NLM     Status:  In-Data-Review    
BACKGROUND AND PURPOSE: The 1/2ABC formula is the method most commonly used in clinical practice to rapidly estimate intracerebral hemorrhage (ICH) volume. We aimed to compare this method with the alternative '2/3Sh' formula for both regularly and irregularly-shaped hematomas.
METHODS: Computed tomography (CT) images from 344 ICH patients (median volume: 16·66 ml) were retrospectively reviewed. According to the maximum slice, the shape was classified into regular or irregular (multilobular, conical, and other). Volumes as determined by the 1/2ABC and 2/3Sh formulas were compared against the gold standard, computer-assisted planimetry, for various hematoma shapes.
RESULTS: With the 1/2ABC method, errors were seen non-significantly more frequently for irregularly-shaped hematomas [OR: 2·85 (95% CI: 0·65-12·50)]. The 1/2ABC method misclassified a greater proportion of hematomas as greater or less than 30 ml in volume: 7·0% (95% CI: 6·0-9·9%). Both the 1/2ABC and 2/3Sh formulas correlated well with gold standard (correlation coefficients >0·9 for each shape). While there was no statistically significant measurement error bias for either method, the 95% confidence intervals of the limit of agreement for 2/3Sh were tighter: -0·22 ml (-4·7-4·25 ml) versus 2·50 ml (-10·35-15·34 ml). Measurement errors were significantly greater with the 1/2ABC method, for both regular and irregular hematomas [1·17 ml (0·48-2·83 ml) versus 0·88 ml (0·42-1·68 ml) and 2·65 ml (1·07-5·88 ml) versus 0·99 ml (0·47-2·28 ml); P<0·05, respectively], although the magnitude of error would only rarely be clinically relevant for regular hematomas. Errors were most evident in assessing multilobular-shaped hematomas [6·49 ml (3·35-13·98 ml) versus 1·86 ml (0·96-9·94 ml); P<0·001].
CONCLUSIONS: The 2/3Sh formula leads to fewer clinically-relevant hematoma volume misclassifications than the 1/2ABC formula, and is particularly superior in estimating volumes of irregularly-shaped hematomas.
Jing Yan; Kaijun Zhao; Jialan Sun; Wanlin Yang; Yulan Qiu; Timothy Kleinig; Yi Fu; Shengdi Chen
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Neurological research     Volume:  35     ISSN:  1743-1328     ISO Abbreviation:  Neurol. Res.     Publication Date:  2013 May 
Date Detail:
Created Date:  2013-04-01     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7905298     Medline TA:  Neurol Res     Country:  England    
Other Details:
Languages:  eng     Pagination:  382-8     Citation Subset:  IM    
Shanghai Jiaotong University School of Medicine, Shanghai, China.
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