ANAID-ICH nomogram for predicting unfavorable outcome after intracerebral hemorrhage.
ANAID-ICH nomogram for predicting unfavorable outcome after intracerebral hemorrhage.
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预测脑出血后不良结局的ANAID - ICH列线图
DOI：
10.1111/cns.13941
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发表时间：
2022-12
影响因子：
5.5
通讯作者：
中科院分区：
文献类型：
--
作者：
弥散加权成像病变（DWIL）与脑出血（ICH）的不良结局相关。我们提出了一种新的预测诺模图纳入DWIL。在一家三级医院，共738例原发性ICH患者前瞻性入选为培训队列。DWI定义为DWI上远灶性高信号，对应表观扩散系数图像上的低信号，远离局灶性血肿。感兴趣的结局是发病后90天时改良的兰金量表评分为4 - 6分。多元逻辑回归被用来构建诺模图。模型性能在培训队列中进行了测试，并在另一个研究所进行了关于辨别力、校准和临床有用性的外部验证。此外，诺模图与ICH评分的预测能力进行了比较。总体而言，在训练和验证队列中分别有153例（20.73%）和23例（15.54%）患者出现了不利结局。多变量分析显示，年龄、国立卫生研究院卒中量表（NIHSS）评分、贫血、幕下位置、DWIL的存在和既往ICH与不良结局相关。我们的ANAID-ICH诺模图是根据上述变量构建的;训练集和验证集的受试者工作特征曲线下面积分别为0.842和0.831。关于90天结局，列线图显示两个队列的预测值均显著高于ICH评分。包括年龄、NIHSS评分、贫血、幕下位置、是否存在DWIL和既往ICH的ANAID-ICH列线图可能有助于识别不良结局风险较高的患者。使用738例原发性ICH患者的数据，本研究确定了90天不利结局的6个预测因素，包括年龄、NIHSS评分、贫血、幕下位置、DWIL的存在和既往ICH。一种新的诺模图基于这些因素显示出显着的歧视和校准的训练和验证集，分别。这可能有助于临床决策和患者监测。
Diffusion‐weighted imaging lesions (DWILs) are associated with unfavorable outcome in intracerebral hemorrhage (ICH). We proposed a novel predictive nomogram incorporating DWILs. A total of 738 patients with primary ICH in a tertiary hospital were prospectively enrolled as a training cohort. DWILs were defined as remote focal hyperintensities on DWI corresponding to low intensities on apparent diffusion coefficient images and remote from the focal hematoma. The outcome of interest was modified Rankin Scale scores of 4–6 at 90 days after onset. Multivariate logistic regression was used to construct a nomogram. Model performance was tested in the training cohort and externally validated with respect to discrimination, calibration, and clinical usefulness in another institute. Additionally, the nomogram was compared with the ICH score in terms of predictive ability. Overall, 153 (20.73%) and 23 (15.54%) patients developed an unfavorable outcome in the training and validation cohorts, respectively. The multivariate analysis revealed that age, National Institutes of Health Stroke Scale (NIHSS) score, anemia, infratentorial location, presence of DWILs, and prior ICH were associated with unfavorable outcome. Our ANAID‐ICH nomogram was constructed according to the aforementioned variables; the area under the receiver operating characteristic curve was 0.842 and 0.831 in the training and validation sets, respectively. With regard to the 90‐day outcome, the nomogram showed a significantly higher predictive value than the ICH score in both cohorts. The ANAID‐ICH nomogram comprising age, NIHSS score, anemia, infratentorial location, presence of DWILs, and prior ICH may facilitate the identification of patients at higher risk for an unfavorable outcome. Using data from 738 patients with primary ICH, this study identifies 6 predictors for 90‐day unfavorable outcomes, including age, NIHSS score, anemia, infratentorial location, presence of DWILs, and prior ICH. A novel nomogram based on these factors shows remarkable discrimination and calibration in the training and validation sets, respectively. It may be helpful for clinical decision‐making and patients surveillance.
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影响因子：
5.5
作者：
Novakovic N;Wilseck ZM;Chenevert TL;Xi G;Keep RF;Pandey AS;Chaudhary N
通讯作者：
Chaudhary N
影响因子：
11.2
作者：
Menon, Ravi S.;Burgess, Richard E.;Wing, Jeffrey J.;Gibbons, M. Christopher;Shara, Nawar M.;Fernandez, Stephen;Jayam-Trouth, Annapurni;German, Laura;Sobotka, Ian;Edwards, Dorothy;Kidwell, Chelsea S.
通讯作者：
Kidwell, Chelsea S.
血压降低，MRI的扩散降低以及脑出血后的结果。
影响因子：
8.3
作者：
Garg RK;Liebling SM;Maas MB;Nemeth AJ;Russell EJ;Naidech AM
通讯作者：
Naidech AM
影响因子：
8.3
作者：
Hemphill, JC;Bonovich, DC;Johnston, SC
通讯作者：
Johnston, SC
影响因子：
9.9
作者：
Kimberly, W. T.;Gilson, A.;Greenberg, S. M.
通讯作者：
Greenberg, S. M.