INTRACEREBRAL HEMORRHAGE - EXTERNAL VALIDATION AND EXTENSION OF A MODEL FOR PREDICTION OF 30-DAY SURVIVAL
INTRACEREBRAL HEMORRHAGE - EXTERNAL VALIDATION AND EXTENSION OF A MODEL FOR PREDICTION OF 30-DAY SURVIVAL
复制标题
DOI：
10.1002/ana.410290614
复制
发表时间：
1991-06-01
影响因子：
11.2
通讯作者：
KASE, CS
中科院分区：
文献类型：
--
作者：
TUHRIM, S;DAMBROSIA, JM;KASE, CS
我们报告了一个先前报道的逻辑回归模型的有效性，该模型使用独立的前瞻性收集的数据预测幕上脑出血后30天的生存率。 原始模型使用初始格拉斯哥昏迷量表评分、出血量和脉压，可解释Pilot卒中数据库中92%患者30天的死亡率或生存率，灵敏度为0.84，特异性为0.96。 对于外部验证，该模型用于预测主期卒中数据库中可获得完整风险因素信息的每位患者的30天状态。 总体而言，90%的患者的结果被正确预测，灵敏度为0.85，特异性为0.92。 对飞行员卒中数据库中未收集的两个因素，高血糖和脑室内出血扩展进行评估，以确定它们是否提供了30天死亡率的额外预测信息。 在逻辑回归分析中，脑室内出血扩展提供了显著的预测信息，而高血糖则没有。 由此产生的四因素模型与相互作用项（脑室内出血扩展和格拉斯哥昏迷量表评分）正确分类94%的患者在30天的生存状态。 一个更一般的结果，死亡或未能达到一个“良好”的日常生活活动评分的一年，分析了同样的四个因素。 由此产生的模型正确分类了队列中95%的患者。
We report validation of a previously reported logistic regression model for predicting 30-day survival after supratentorial intracerebral hemorrhage using independent, prospectively collected data. The original model, using initial Glasgow Coma Scale score, hemorrhage size, and pulse pressure, accounted for mortality or survival at 30 days in 92% of patients in the Pilot Stroke Data Bank with a sensitivity of 0.84 and a specificity of 0.96. For external validation, the model was used to predict 30-day status for each patient in the Main Phase Stroke Data Bank for whom complete risk factor information was available. Overall, 90% of patients' outcomes were correctly predicted with a sensitivity of 0.85 and a specificity of 0.92. Two factors not collected in the Pilot Stroke Data Bank, hyperglycemia and intraventricular hemorrhage extension, were assessed to determine if they provided additional predictive information on 30-day mortality. Intraventricular hemorrhage extension contributed significant predictive information in a logistic regression, whereas hyperglycemia did not. The resulting four-factor model with an interaction term (intraventricular hemorrhage extension and Glasgow Coma Scale score) correctly classified the survival status of 94% of patients at 30 days. A more general outcome, death or failure to achieve a "good" Activities of Daily Living Score by one year, was analyzed with respect to the same four factors. The resulting model correctly classified 95% of the patients in the cohort.