scholarly journals Location-Specific Radiomics Score: Novel Imaging Marker for Predicting Poor Outcome of Deep and Lobar Spontaneous Intracerebral Hemorrhage

2021 ◽  
Vol 15 ◽  
Author(s):  
Zhiming Zhou ◽  
Hongli Zhou ◽  
Zuhua Song ◽  
Yuanyuan Chen ◽  
Dajing Guo ◽  
...  
Keyword(s):  
Intracerebral Hemorrhage ◽  
Characteristic Curve ◽  
Clinical Trial Design ◽  
Spontaneous Intracerebral Hemorrhage ◽  
Combined Model ◽  
Derivation Cohort ◽  
Poor Outcome ◽  
Combined Models ◽  
Poor Outcomes ◽  
Noncontrast Computed Tomography

Objective: To derive and validate a location-specific radiomics score (Rad-score) based on noncontrast computed tomography for predicting poor deep and lobar spontaneous intracerebral hemorrhage (SICH) outcome.Methods: In total, 494 SICH patients from multiple centers were retrospectively reviewed. Poor outcome was considered mRS 3–6 at 6 months. The Rad-score was derived using optimal radiomics features. The optimal location-specific Rad-score cut-offs for poor deep and lobar SICH outcomes were identified using receiver operating characteristic curve analysis. Univariable and multivariable analyses were used to determine independent poor outcome predictors. The combined models for deep and lobar SICH were constructed using independent predictors of poor outcomes, including dichotomized Rad-score in the derivation cohort, which was validated in the validation cohort.Results: Of 494 SICH patients, 392 (79%) had deep SICH, and 373 (76%) had poor outcomes. The Glasgow Coma Scale score, haematoma enlargement, haematoma location, haematoma volume and Rad-score were independent predictors of poor outcomes (all P < 0.05). Cut-offs of Rad-score, 82.90 (AUC = 0.794) in deep SICH and 80.77 (AUC = 0.823) in lobar SICH, were identified for predicting poor outcomes. For deep SICH, the AUCs of the combined model were 0.856 and 0.831 in the derivation and validation cohorts, respectively. For lobar SICH, the combined model AUCs were 0.866 and 0.843 in the derivation and validation cohorts, respectively.Conclusion: Location-specific Rad-scores and combined models can identify subjects at high risk of poor deep and lobar SICH outcomes, which could improve clinical trial design by screening target patients.

Abstract TP326: Lymphopenia, Infectious Complications and Outcome in Spontaneous Intracerebral Hemorrhage

Stroke ◽  
2017 ◽  
Vol 48 (suppl_1) ◽  
Author(s):  
Andrea Morotti ◽  
Sandro Marini ◽  
Michael J Jessel ◽  
Kristin Schwab ◽  
Alison M Ayres ◽  
...  
Keyword(s):  
Intracerebral Hemorrhage ◽  
Lymphocyte Count ◽  
Cox Regression ◽  
Case Fatality ◽  
Retrospective Chart Review ◽  
Infectious Complications ◽  
Multiple Infections ◽  
Spontaneous Intracerebral Hemorrhage ◽  
Poor Outcome ◽  
Increased Risk

Background and Purpose: lymphopenia is increasingly recognized as a consequence of acute illness and may predispose to infections. We investigated whether admission lymphopenia (AL) is associated with increased risk of infectious complications and poor outcome in patients with spontaneous intracerebral hemorrhage (ICH). Methods: we analyzed a prospectively collected cohort of ICH patients ascertained between 1994 and 2015. Subjects were included if they had a lymphocyte count obtained within 24 h from onset and AL was defined as lymphocyte count<1000/uL. Infectious complications were assessed through retrospective chart review and the association between AL, infectious complications and mortality was investigated with a multivariable Cox regression and logistic regression respectively. Results: 2014 patients met the inclusion criteria (median age 75, males 54.0%) of whom 548 (27.2%) had AL and 605 (30.0%) experienced an infectious complication. Overall case fatality at 90 days was 36.9%. Patients with AL were more severely affected, as highlighted by larger hematoma volume, higher frequency of intraventricular hemorrhage and lower Glasgow Coma Scale score (all p<0.001). AL was independently associated with increased risk of pneumonia (Hazard Ratio [HR] 1.65, 95% confidence interval [CI] 1.32-2.05, p<0.001) and multiple infections (HR 1.75, 95% CI 1.22-2.51, p=0.002). The association with urinary tract infection, sepsis or other infections was not significant. AL was also an independent predictor of 90-day mortality (odds ratio 1.55, 95% CI 1.18-2.04, p=0.002) after adjusting for confounders. Conclusions: AL is common in ICH and associated with increased risk of infectious complications and poor outcome. Further studies will be needed to determine whether prophylactic antibiotics in ICH patients with AL can improve outcome.

scholarly journals Prognostic value of diffusion-weighted MRI for post-cardiac arrest coma

Neurology ◽  
2020 ◽  
Vol 94 (16) ◽  
pp. e1684-e1692 ◽  
Author(s):  
Karen G. Hirsch ◽  
Nancy Fischbein ◽  
Michael Mlynash ◽  
Stephanie Kemp ◽  
Roland Bammer ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Brain Tissue ◽  
Characteristic Curve ◽  
Area Under The Curve ◽  
Poor Outcome ◽  
Diffusion Weighted ◽  
Blinded Study ◽  
Apparent Diffusion ◽  
Adc Values ◽  
Poor Outcomes

ObjectiveTo validate quantitative diffusion-weighted imaging (DWI) MRI thresholds that correlate with poor outcome in comatose cardiac arrest survivors, we conducted a clinician-blinded study and prospectively obtained MRIs from comatose patients after cardiac arrest.MethodsConsecutive comatose post-cardiac arrest adult patients were prospectively enrolled. MRIs obtained within 7 days after arrest were evaluated. The clinical team was blinded to the DWI MRI results and followed a prescribed prognostication algorithm. Apparent diffusion coefficient (ADC) values and thresholds differentiating good and poor outcome were analyzed. Poor outcome was defined as a Glasgow Outcome Scale score of ≤2 at 6 months after arrest.ResultsNinety-seven patients were included, and 75 patients (77%) had MRIs. In 51 patients with MRI completed by postarrest day 7, the prespecified threshold of >10% of brain tissue with an ADC <650 ×10−6 mm2/s was highly predictive for poor outcome with a sensitivity of 0.63 (95% confidence interval [CI] 0.42–0.80), a specificity of 0.96 (95% CI 0.77–0.998), and a positive predictive value (PPV) of 0.94 (95% CI 0.71–0.997). The mean whole-brain ADC was higher among patients with good outcomes. Receiver operating characteristic curve analysis showed that ADC <650 ×10−6 mm2/s had an area under the curve of 0.79 (95% CI 0.65–0.93, p < 0.001). Quantitative DWI MRI data improved prognostication of both good and poor outcomes.ConclusionsThis prospective, clinician-blinded study validates previous research showing that an ADC <650 ×10−6 mm2/s in >10% of brain tissue in an MRI obtained by postarrest day 7 is highly specific for poor outcome in comatose patients after cardiac arrest.

Nosocomial Infections in Patients With Spontaneous Intracerebral Hemorrhage

2015 ◽  
Vol 24 (3) ◽  
pp. 227-231 ◽  
Author(s):  
Archana Hinduja ◽  
Jamil Dibu ◽  
Eugene Achi ◽  
Anand Patel ◽  
Rohan Samant ◽  
...  
Keyword(s):  
Nosocomial Infection ◽  
Intracerebral Hemorrhage ◽  
Nosocomial Infections ◽  
Odds Ratio ◽  
Intraventricular Hemorrhage ◽  
Univariate Analysis ◽  
Multivariate Regression Analysis ◽  
Spontaneous Intracerebral Hemorrhage ◽  
Percutaneous Gastrostomy ◽  
Poor Outcome

Background Nosocomial infections are frequent complications in patients with intracerebral hemorrhage. Objectives To determine the prevalence, risk factors, and outcomes of nosocomial infections in patients with intracerebral hemorrhage. Methods Prospectively collected data on patients with spontaneous intracerebral hemorrhage between January 2009 and June 2012 were retrospectively reviewed. Patients who had nosocomial infection during the hospital stay were compared with patients who did not. Poor outcome was defined as death or discharge to a long-term nursing facility. Results At least 1 nosocomial infection developed in 26% of 202 patients with intracerebral hemorrhage. The most common infections were pneumonia (18%), urinary tract infection (12%), meningitis or ventriculitis (3%), and bacteremia (1%). On univariate analysis, independent predictors of nosocomial infection were intraventricular hemorrhage, hydrocephalus, low score on the Glasgow Coma Scale at admission, hyperglycemia at admission, and treatment with mechanical ventilation. On multivariate regression analysis, the only significant predictor of nosocomial infection was intraventricular hemorrhage (odds ratio, 5.4; 95% CI, 1.2–11.4; P = .02). Patients with nosocomial infection were more likely than those without to require a percutaneous gastrostomy tube (odds ratio, 33.1, 95% CI, 23.3–604.4; P &lt; .001) and to have a longer stay in the intensive care unit or hospital without a significant increase in mortality. Patients with nosocomial pneumonia were also more likely to have a poor outcome (P &lt; .001). Conclusion Pneumonia was the most common infection among patients with intracerebral hemorrhage.

scholarly journals Noncontrast Computed Tomography Hypodensities Predict Poor Outcome in Intracerebral Hemorrhage Patients

Stroke ◽  
2016 ◽  
Vol 47 (10) ◽  
pp. 2511-2516 ◽  
Author(s):  
Gregoire Boulouis ◽  
Andrea Morotti ◽  
H. Bart Brouwers ◽  
Andreas Charidimou ◽  
Michael J. Jessel ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Intracerebral Hemorrhage ◽  
Poor Outcome ◽  
Noncontrast Computed Tomography

Irregular Shape as An Independent Predictor of Prognosis in Patients with Primary Intracerebral Hemorrhage

2021 ◽  
Author(s):  
Chunyang Liu ◽  
Haopeng Zhang ◽  
Lixiang Wang ◽  
Qiuyi Jiang ◽  
Enzhou Lu ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Logistic Regression ◽  
Intracerebral Hemorrhage ◽  
Functional Outcome ◽  
Functional Outcomes ◽  
Irregular Shape ◽  
Spontaneous Intracerebral Hemorrhage ◽  
Poor Outcome ◽  
Irregular Shapes ◽  
D Dimer

Abstract BACKGROUND AND PURPOSE The utility of non-contrast computed tomography (NCCT) markers in the prognosis of spontaneous intracerebral hemorrhage (ICH) has been concerned. This study aimed to investigate the predictive value of the computed tomography irregularity shape for poor functional outcomes in patients with spontaneous intracerebral hemorrhage. PATIENTS AND Methods: We retrospectively reviewed all 782 patients with intracranial hemorrhage in our stroke emergency center from January 2018 to September 2019. Laboratory examination and CT examination were measured within 24 hours of admission. After three months, the patient's functional outcome was assessed using the modified Rankin Scale (mRS). Multinomial logistic regression analyses were applied to identify independent predictors of functional outcome in patients with intracerebral hemorrhage. RESULTS Out of the 627 patients included in this study, those with irregular shapes on CT imaging had a higher proportion of poor outcome and mortality 90 days after discharge (P<0.001). Irregular shapes were found to be significant independent predictors of poor outcome and mortality on multiple logistic regression analysis. Besides, the increase of plasma D-dimer was associated with the occurrence of irregular shape (P=0.0387). CONCLUSIONS Patients with irregular shape showed worse functional outcomes after intracerebral hemorrhage. The elevated expression level of plasma D-dimer may be directly related to the formation of irregular shapes.

Lateral Ventricular Volume Asymmetry Predicts Poor Outcome After Spontaneous Intracerebral Hemorrhage

2018 ◽  
Vol 110 ◽  
pp. e958-e964 ◽  
Author(s):  
Jigang Chen ◽  
Danfeng Zhang ◽  
Zhenxing Li ◽  
Yan Dong ◽  
Kaiwei Han ◽  
...  
Keyword(s):  
Intracerebral Hemorrhage ◽  
Ventricular Volume ◽  
Spontaneous Intracerebral Hemorrhage ◽  
Poor Outcome

scholarly journals Serum glucose and potassium ratio as a predictive factor for prognosis of acute intracerebral hemorrhage

2021 ◽  
Vol 49 (4) ◽  
pp. 030006052110096
Author(s):  
Xiao-Yu Wu ◽  
Yao-Kun Zhuang ◽  
Yong Cai ◽  
Xiao-Qiao Dong ◽  
Ke-Yi Wang ◽  
...  
Keyword(s):  
Intracerebral Hemorrhage ◽  
Characteristic Curve ◽  
Serum Glucose ◽  
Clinical Variable ◽  
Hematoma Volume ◽  
Nihss Score ◽  
Patients At Risk ◽  
Acute Intracerebral Hemorrhage ◽  
Poor Outcomes ◽  
Gcs Score

Objective The serum glucose/potassium ratio (GPR) is a potential prognostic predictor for acute brain injury-related diseases. We calculated the serum GPR in patients with acute intracerebral hemorrhage (ICH) and explored its prognostic value for long-term prognoses and ICH severity. Methods This retrospective cohort study consecutively included 92 patients with ICH and 92 healthy controls. The National Institutes of Health Stroke Scale (NIHSS) score, Glasgow coma scale (GCS) score, and hematoma volume were used to assess severity. A modified Rankin Scale score > 2 at 90 days post-stroke was defined as a poor outcome. Results The serum GPR was significantly higher in patients than controls. The serum GPR was weakly correlated with the NIHSS score, GCS score, and hematoma volume. The serum GPR, GCS score, and hematoma volume were independently associated with poor outcomes. In the receiver operating characteristic curve analysis, the serum GPR remarkably discriminated patients at risk of poor outcomes at 90 days. The serum GPR significantly improved the prognostic predictive capability of hematoma volume and tended to increase that of the GCS score. Conclusion Serum GPR is an easily obtained clinical variable for predicting clinical outcomes after ICH.

scholarly journals Plasma D‐dimer predicts poor outcome and mortality after spontaneous intracerebral hemorrhage

2020 ◽  
Author(s):  
Qi Zhou ◽  
Daming Zhang ◽  
Xin Chen ◽  
Zhao Yang ◽  
Zhihui Liu ◽  
...  
Keyword(s):  
Intracerebral Hemorrhage ◽  
Spontaneous Intracerebral Hemorrhage ◽  
Poor Outcome ◽  
D Dimer
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