Predicting recovery after intracerebral hemorrhage--an external validation in patients from controlled clinical trials

J Neurol. 2009 Mar;256(3):464-9. doi: 10.1007/s00415-009-0115-z. Epub 2009 Mar 18.

Abstract

Background: An early and reliable prognostic indication in stroke patients is potentially useful for initiation of individual treatment and for informing patients and relatives. We recently developed a regression model as well as a simple 11-point predictive score (Essen ICH score) for functional recovery within three months after acute intracerebral hemorrhage (ICH) based on age and the National Institutes of Health Stroke Scale (NIH-SS). Here, we demonstrate the applicability of our models in an independent sample of ICH patients from controlled clinical trials.

Methods: The prognostic models were used to predict functional recovery in 564 patients from the Virtual International Stroke Trials Archive (VISTA). Furthermore, we tried to improve the accuracy by re-calibration and estimating new model parameters.

Findings: The logistic regression model and the Essen ICH score were able to correctly classify 77.5 % and 76.4 % of patients, respectively. Re-calibration and novel estimation of parameters yielded only a slight improvement of overall predictive accuracy.

Interpretation: For acute ICH patients included in controlled trials, our predictive models based on age and the NIH-SS correctly predict functional recovery after three months and could be useful for future trial design.

MeSH terms

  • Age Factors
  • Aged
  • Aged, 80 and over
  • Algorithms
  • Archives
  • Area Under Curve
  • Cerebral Hemorrhage / diagnosis*
  • Cerebral Hemorrhage / mortality
  • Controlled Clinical Trials as Topic
  • Female
  • Humans
  • Logistic Models
  • Male
  • Middle Aged
  • Models, Theoretical*
  • Neuropsychological Tests*
  • Probability
  • Prognosis
  • Recovery of Function*
  • Severity of Illness Index