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Validation of the ICH score in patients with spontaneous intracerebral haemorrhage admitted to the intensive care unit in Southern Spain

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dc.contributor.author Rodríguez-Fernández, Sonia
dc.contributor.author Castillo-Lorente, Encarnación
dc.contributor.author Guerrero-López, Francisco
dc.contributor.author Rodríguez-Rubio, David
dc.contributor.author Aguilar-Alonso, Eduardo
dc.contributor.author Lafuente Baraza, Jesus
dc.contributor.author Gómez-Jiménez, Francisco Javier
dc.contributor.author Mora-Ordoñez, Juan
dc.contributor.author Rivera-López, Ricardo
dc.contributor.author Arias-Verdú, María Dolores
dc.contributor.author Quesada-García, Guillermo
dc.contributor.author Arráez-Sánchez, Miguel Ángel
dc.contributor.author Rivera-Fernández, Ricardo
dc.date.accessioned 2019-03-15T08:23:34Z
dc.date.available 2019-03-15T08:23:34Z
dc.date.issued 2018
dc.identifier.citation Rodríguez-Fernández S, Castillo-Lorente E, Guerrero-Lopez F, Rodríguez-Rubio D, Aguilar-Alonso E, Lafuente-Baraza J. et al. Validation of the ICH score in patients with spontaneous intracerebral haemorrhage admitted to the intensive care unit in Southern Spain. BMJ Open. 2018 Aug 13;8(8):e021719. DOI: 10.1136/bmjopen-2018-021719
dc.identifier.issn 2044-6055
dc.identifier.uri http://hdl.handle.net/10230/36840
dc.description.abstract OBJECTIVE: Validation of the intracerebral haemorrhage (ICH) score in patients with a diagnosis of spontaneous ICH admitted to the intensive care unit (ICU). METHODS: A multicentre cohort study was conducted in all consecutive patients with ICH admitted to the ICUs of three hospitals with a neurosurgery department between 2009 and 2012 in Andalusia, Spain. Data collected included ICH, Glasgow Coma Scale (GCS) and Acute Physiology and Chronic Health Evaluation II (APACHE-II) scores. Demographic data, location and volume of haematoma and 30-day mortality rate were also collated. RESULTS: A total of 336 patients were included. 105 of whom underwent surgery. Median (IQR) age: 62 (50-70) years. APACHE-II: 21(15-26) points, GCS: 7 (4-11) points, ICH score: 2 (2-3) points. 11.1% presented with bilateral mydriasis on admission (mortality rate=100%). Intraventricular haemorrhage was observed in 58.9% of patients. In-hospital mortality was 54.17% while the APACHE-II predicted mortality was 57.22% with a standardised mortality ratio (SMR) of 0.95 (95% CI 0.81 to 1.09) and a Hosmer-Lemenshow test value (H) of 3.62 (no significant statistical difference, n.s.). 30-day mortality was 52.38% compared with the ICH score predicted mortality of 48.79%, SMR: 1.07 (95% CI 0.91 to 1.23), n.s. Mortality was higher than predicted at the lowest scores and lower than predicted in the more severe patients, (H=55.89, p<0.001), Gruppo Italiano per la Valutazione degli Interventi in Terapia Intensiva calibration belt (p<0.001). The area under a receiver operating characteristic (ROC) curve was 0.74 (95% CI 0.69 to 0.79). CONCLUSIONS: ICH score shows an acceptable discrimination as a tool to predict mortality rates in patients with spontaneous ICH admitted to the ICU, but its calibration is suboptimal.
dc.format.mimetype application/pdf
dc.language.iso eng
dc.publisher BMJ Publishing Group
dc.rights This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.
dc.rights.uri http://creativecommons.org/licenses/by-nc/4.0/
dc.subject.other Hemorràgia cerebral
dc.title Validation of the ICH score in patients with spontaneous intracerebral haemorrhage admitted to the intensive care unit in Southern Spain
dc.type info:eu-repo/semantics/article
dc.identifier.doi http://dx.doi.org/10.1136/bmjopen-2018-021719
dc.subject.keyword ICH score
dc.subject.keyword ICU
dc.subject.keyword Intracerebral haemorrhage
dc.subject.keyword Mortality
dc.subject.keyword Prognostic model
dc.rights.accessRights info:eu-repo/semantics/openAccess
dc.type.version info:eu-repo/semantics/publishedVersion


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