التفاصيل البيبلوغرافية
| العنوان: |
Predicting the presence of macrovascular causes in non-traumatic intracerebral haemorrhage: the DIAGRAM prediction score |
| المؤلفون: |
Hilkens, Nina A, van Asch, Charlotte J J, Werring, David J, Wilson, Duncan, Rinkel, Gabriël J E, Algra, Ale, Velthuis, Birgitta K, de Kort, Gérard A P, Witkamp, Theo D, van Nieuwenhuizen, Koen M, de Leeuw, Frank-Erik, Schonewille, Wouter J, de Kort, Paul L M, Dippel, Diederik W J, Raaymakers, Theodora W M, Hofmeijer, Jeannette, Wermer, Marieke J H, Kerkhoff, Henk, Jellema, Korné, Bronner, Irene M, Remmers, Michel J M, Bienfait, Henri Paul, Witjes, Ron J G M, Jäger, H Rolf, Greving, Jacoba P, Klijn, Catharina J M |
| المساهمون: |
Hartstichting, ZonMw |
| المصدر: |
Journal of Neurology, Neurosurgery & Psychiatry ; volume 89, issue 7, page 674-679 ; ISSN 0022-3050 1468-330X |
| بيانات النشر: |
BMJ |
| سنة النشر: |
2018 |
| الوصف: |
Objective A substantial part of non-traumatic intracerebral haemorrhages (ICH) arises from a macrovascular cause, but there is little guidance on selection of patients for additional diagnostic work-up. We aimed to develop and externally validate a model for predicting the probability of a macrovascular cause in patients with non-traumatic ICH. Methods The DIagnostic AngioGRAphy to find vascular Malformations (DIAGRAM) study (n=298; 69 macrovascular cause; 23%) is a prospective, multicentre study assessing yield and accuracy of CT angiography (CTA), MRI/ magnetic resonance angiography (MRA) and intra-arterial catheter angiography in diagnosing macrovascular causes in patients with non-traumatic ICH. We considered prespecified patient and ICH characteristics in multivariable logistic regression analyses as predictors for a macrovascular cause. We combined independent predictors in a model, which we validated in an external cohort of 173 patients with ICH (78 macrovascular cause, 45%). Results Independent predictors were younger age, lobar or posterior fossa (vs deep) location of ICH, and absence of small vessel disease (SVD). A model that combined these predictors showed good performance in the development data (c-statistic 0.83; 95% CI 0.78 to 0.88) and moderate performance in external validation (c-statistic 0.66; 95% CI 0.58 to 0.74). When CTA results were added, the c-statistic was excellent (0.91; 95% CI 0.88 to 0.94) and good after external validation (0.88; 95% CI 0.83 to 0.94). Predicted probabilities varied from 1% in patients aged 51–70 years with deep ICH and SVD, to more than 50% in patients aged 18–50 years with lobar or posterior fossa ICH without SVD. Conclusion The DIAGRAM scores help to predict the probability of a macrovascular cause in patients with non-traumatic ICH based on age, ICH location, SVD and CTA. |
| نوع الوثيقة: |
article in journal/newspaper |
| اللغة: |
English |
| DOI: |
10.1136/jnnp-2017-317262 |
| الإتاحة: |
https://doi.org/10.1136/jnnp-2017-317262Test |
| رقم الانضمام: |
edsbas.8A4DA3EE |
| قاعدة البيانات: |
BASE |
