Format

Send to

Choose Destination
J Neurol Sci. 2020 Feb 15;409:116628. doi: 10.1016/j.jns.2019.116628. Epub 2019 Dec 16.

The prognostic utility of ICH-score in anticoagulant related intracerebral hemorrhage.

Author information

1
Division of Neurology, McMaster University, Population Health Research Institute, Hamilton, ON, Canada. Electronic address: ar.katsanos@gmail.com.
2
Department of Neurology, St. Josef-Hospital, Ruhr University of Bochum, Bochum, Germany.
3
Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA.
4
Department of Neurology, University of Tennessee Health Science Center, Memphis, TN, USA.
5
Department of Neurology, Geisinger Medical Center, Danville, PA, USA.
6
Division of Neurology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
7
Department of Neurology, Henry Ford Hospital, Detroit, MI, USA.
8
Allegheny Health Network, Pittsburgh, PA, USA.
9
Stroke Unit, Division of Cardiovascular Medicine, University of Perugia, Italy.
10
Department of Neurology, Essentia Health-Duluth Clinic, MN, USA.
11
Department of Critical Care Medicine, MedStar Washington Hospital Center, Washington, DC, USA.
12
Second Department of Neurology, AHEPA University Hospital, Aristotelian University of Thessaloniki, Thessaloniki, Greece.
13
Acute Stroke Unit, Metropolitan Hospital, Piraeus, Greece.
14
Department of Neurology, University of Thessaly, Larissa, Greece.
15
Department of Neurosurgery, Georgetown University, Washington, DC, USA.
16
Laboratory of Haematology and Blood Bank Unit, "Attikon" Hospital, School of Medicine, National and Kapodistrian University of Athens, Greece.
17
Department of Neurosurgery, "Attikon" Hospital, National and Kapodistrian University of Athens, School of Medicine, Athens, Greece.
18
Second Department of Internal Medicine, Attikon University Hospital, National and Kapodistrian University of Athens, Athens, Greece.
19
Division of Neurology, McMaster University, Population Health Research Institute, Hamilton, ON, Canada.
20
Department of Neurology, Henry Ford Hospital, Detroit, MI, USA; Department of Neurology, School of Medicine, University of Crete, Crete, Greece.
21
Department of Neurology, University of Tennessee Health Science Center, Memphis, TN, USA; Second Department of Neurology, "Attikon" University Hospital, School of Medicine, National & Kapodistrian University of Athens, Athens, Greece.

Abstract

Although intracerebral hemorrhage (ICH) score is used to provide an estimate on the probability of mortality following spontaneous ICH of any cause, its utility has not been exclusively tested in ICH patients with history of treatment with vitamin K antagonists (VKAs) or non-vitamin K oral anticoagulants (NOACs). The aim of the present report is to investigate the utility of ICH score for mortality prognostication of VKA-ICH and NOAC-ICH patients. We used receiver operating characteristic curve analyses to estimate the accuracy parameters for the different values of ICH score in the prognosis of mortality within 30-days after the onset of NOAC-ICH or VKA-ICH. We analyzed data from 108 NOAC-ICH and 241 VKA-ICH patients (median age 76 years, 58% males, median NIHSS score 11 points, median ICH-score 2 points). ICH score of 4 points was uncovered to be the most favorable threshold for the prediction of 30-day mortality both after NOAC-ICH (sensitivity: 57.7%, specificity: 98.8%) or VKA-ICH (sensitivity: 42.1%, specificity: 92.6%). However, comparison of the areas under the curve (AUC) suggested a cumulatively higher (p = .001) predictive value of ICH-score in the prognostication of 30-day mortality after ICH related to the use of NOACs (AUC: 0.92, 95%CI: 0.86-0.98) compared to the ICH related to the use of VKAs (AUC: 0.77, 95%CI: 0.70-0.83). In conclusion, ICH score seems to have an adequate predictive utility in the prognostication of 30-day mortality following an ICH related to the use of oral anticoagulants, with better yield in ICH cases associated with the use of NOACs.

PMID:
31862517
DOI:
10.1016/j.jns.2019.116628

Supplemental Content

Full text links

Icon for Elsevier Science
Loading ...
Support Center