Document Detail


The IVH score: a novel tool for estimating intraventricular hemorrhage volume: clinical and research implications.
MedLine Citation:
PMID:  19237905     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: Intraventricular extension of intracerebral hemorrhage (IVH) is an independent predictor of poor outcome. IVH volume may be important in outcome prediction and management; however, it is difficult to measure routinely. DESIGN AND PATIENTS: We reviewed the charts and computed tomographies of a cohort of consecutive patients with IVH. The cohort was divided into two groups: index and validation by random sampling. IVH and intracerebral hemorrhage (ICH) volume were measured manually in all patients. IVH was also graded using a simple classification system termed IVH score (IVHS). Clinical outcome was determined by the modified Rankin Scale (mRS) at discharge and in-hospital death. Poor outcome was defined as mRS 4-6. MAIN RESULTS: One hundred seventy-five patients were analyzed, 92 in the index group and 83 in the validation group. Exponential regression yielded the following formula for estimating IVH volume (mL): eIVHS/5 (R = .75, p < 0.001). The IVH estimation formula was then verified in the validation group (R = .8, p < 0.001). The following correlations with mRS were obtained: IVH volume R = .305; ICH volume R = .468; total volume [TV] R = .571 (p < 0.001 for all three correlations). Partial correlation of TV with mRS controlling for ICH volume yielded R = .3 for TV (p < 0.001). Logistic regression model comparing ICH and TV association with poor outcome yielded the following: ICH odds ratio = 5.2, 95% confidence interval 2.3-11.6, p < 0.001; TV odds ratio = 41.6, 95% confidence interval 9.6-180.6, p < 0.001. Substituting TV for ICH volume in the ICH score resulted in a significant increase in the specificity from 64% to 87% for predicting mortality. CONCLUSIONS: IVHS enables clinicians to rapidly estimate IVH volume. The addition of IVH to ICH volume increases its predictive power for poor outcome and mortality significantly. IVHS and TV may be used in clinical practice and clinical trials of patients with ICH.
Authors:
Hen Hallevi; Nabeel S Dar; Andrew D Barreto; Miriam M Morales; Sheryl Martin-Schild; Anitha T Abraham; Kyle C Walker; Nicole R Gonzales; Kachikwu Illoh; James C Grotta; Sean I Savitz
Related Documents :
20207505 - Rapidarc radiation therapy: first year experience at the university of alabama at birmi...
8727815 - Gamma knife radiosurgery for arteriovenous malformations: long-term follow-up results f...
19173095 - Volume-dependent overestimation of spontaneous intracerebral hematoma volume by the abc...
23887075 - The optimum number of oocytes in ivf treatment: an analysis of 2455 cycles in china.
1855185 - The clinical and endocrine outcome to trans-sphenoidal microsurgery of nonsecreting pit...
17597405 - Long-term outcomes of acute gastric variceal bleeding in 48 patients following treatmen...
Publication Detail:
Type:  Journal Article; Validation Studies    
Journal Detail:
Title:  Critical care medicine     Volume:  37     ISSN:  1530-0293     ISO Abbreviation:  Crit. Care Med.     Publication Date:  2009 Mar 
Date Detail:
Created Date:  2009-02-24     Completed Date:  2009-03-25     Revised Date:  2010-09-23    
Medline Journal Info:
Nlm Unique ID:  0355501     Medline TA:  Crit Care Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  969-74, e1     Citation Subset:  AIM; IM    
Affiliation:
Department of Neurology, University of Texas Health Science Center at Houston, Houston, TX, USA. hen.hallevi@gmail.com
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
Cerebral Hemorrhage / pathology*
Cerebral Ventricles*
Humans
Middle Aged
Prognosis
Retrospective Studies
Severity of Illness Index
Grant Support
ID/Acronym/Agency:
P50 NS044227-019002/NS/NINDS NIH HHS
Comments/Corrections
Comment In:
Crit Care Med. 2009 Mar;37(3):1152-3   [PMID:  19237944 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


Previous Document:  Middle cerebral artery vasospasm: transcranial color-coded duplex sonography versus conventional non...
Next Document:  Pronounced platelet hyperfunction in patients with cardiac arrest achieving restoration of spontaneo...