Predictive value of emergency intracerebral hemorrhage grading scale for adverse prognosis in patients with intracerebral hemorrhage
10.3760/cma.j.cn101721-20230910-00067
- VernacularTitle:急诊脑出血分级量表对脑出血患者不良预后的预测价值
- Author:
Guangnian QIAO
1
;
Yao XIAO
;
Yong SUN
;
Dapeng DAI
;
Aimin LI
Author Information
1. 徐州医科大学附属连云港医院 连云港市第一人民医院神经外科，连云港 222000
- Keywords:
Cerebral hemorrhage;
Emergency cerebral hemorrhage grading scale score;
Modified emergency cerebral hemorrhage grading scale score;
Prognosis
- From:
Clinical Medicine of China
2024;40(3):169-175
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To study the emergency cerebral hemorrhage grading scale (EDICH) score and the modified emergency intracerebral hemorrhage grading scale (mEDICH) score on the adverse prognosis of patients with cerebral hemorrhage 90 days after discharge.Methods:The clinical data of 248 patients with cerebral hemorrhage in the Department of Neurosurgery, Lianyungang Hospital Affiliated to Xuzhou Medical University from January 2022 to December 2022 were retrospectively analyzed. According to the modified Rankin scale (mRS) 90 days after discharge, patients were divided into a good prognosis group (212 cases) and a poor prognosis group (36 cases). Independent-samples t-test and rank-sum test were used to compare the basic information, vital signs, laboratory tests, imaging characteristics, EDICH score and mEDICH score of the two groups. Multivariate Logistic regression was used to analyze the risk factors affecting the poor prognosis of patients with cerebral hemorrhage. The receiver operating characteristic (ROC) curve was drawn to analyze the predictive value of EDICH score and mEDICH score for the poor prognosis of patients with intracerebral hemorrhage 90 days after discharge.Results:The diameter of intracerebral hematoma (5.53±0.32) cm, the rate of intraventricular hemorrhage (61.11%,22/36) and the rate of subtentorial hemorrhage (27.78%, 10/36) in poor prognosis group were significantly higher than those in good prognosis group (3.50±0.07) cm, intraventricular hemorrhage (30.19%, 64/212) and infratentorial hemorrhage (14.15%, 30/212), the differences were statistically significant ( t=6.19, P<0.001; χ 2=12.99, P<0.001; χ 2=4.22, P=0.040). GCS scores in the poor prognosis group were lower than those in the good prognosis group ( H=72.01, P<0.001). EDICH scores and mEDICH scores in the poor prognosis group were higher than those in the good prognosis group (EDICH score: H=65.79, P<0.001; mEDICH score: H=76.56, P<0.001). Multivariate Logistic regression analysis showed EDICH score ( OR=5.869,95% CI 3.451-9.981, P<0.05) and mEDICH score ( OR=10.353,95% CI 4.842-22.137, P<0.05)could predict the prognosis of patients with cerebral hemorrhage 90 days after discharge. ROC curve analysis showed that the sensitivity and specificity of EDICH score and mEDICH score were 0. 861,0.889 and 0. 821,0.953, respectively, but the predictive effect of mEDICH score was significantly better than that of EDICH score ( Kappa values were 0. 787 and 0. 494, respectively). The predicted results are highly consistent with the actual results. Conclusion:MEDICH score can accurately predict the prognosis of patients with intracerebral hemorrhage 90 days after discharge, which has clinical application value.
