MIS Score: Prediction Model for Minimally Invasive Surgery

World Neurosurg. 2017 Mar:99:624-629. doi: 10.1016/j.wneu.2016.12.102. Epub 2016 Dec 31.

Abstract

Background: Reports suggest that patients with spontaneous intracerebral hemorrhage (ICH) can benefit from minimally invasive surgery, but the inclusion criterion for operation is controversial. This article analyzes factors affecting the 30-day prognoses of patients who have received minimally invasive surgery and proposes a simple grading scale that represents clinical operation effectiveness.

Methods: The records of 101 patients with spontaneous ICH presenting to Qianfoshan Hospital were reviewed. Factors affecting their 30-day prognosis were identified by logistic regression. A clinical grading scale, the MIS score, was developed by weighting the independent predictors based on these factors.

Results: Univariate analysis revealed that the factors that affect 30-day prognosis include Glasgow coma scale score (P < 0.01), age ≥80 years (P < 0.05), blood glucose (P < 0.01), ICH volume (P < 0.01), operation time (P < 0.05), and presence of intraventricular hemorrhage (P < 0.001). Logistic regression revealed that the factors that affect 30-day prognosis include Glasgow coma scale score (P < 0.05), age (P < 0.05), ICH volume (P < 0.01), and presence of intraventricular hemorrhage (P < 0.05). The MIS score was developed accordingly; 39 patients with 0-1 MIS scores had favorable prognoses, whereas only 9 patients with 2-5 MIS scores had poor prognoses.

Conclusions: The MIS score is a simple grading scale that can be used to select patients who are suited for minimal invasive drainage surgery. When MIS score is 0-1, minimal invasive surgery is strongly recommended for patients with spontaneous cerebral hemorrhage. The scale merits further prospective studies to fully determine its efficacy.

Keywords: Cerebral hemorrhage; Minimal invasive surgery; Prognostic factors; Scale.

MeSH terms

  • Adolescent
  • Adult
  • Age Factors
  • Aged
  • Aged, 80 and over
  • Blood Glucose / metabolism
  • Cerebral Hemorrhage / diagnostic imaging
  • Cerebral Hemorrhage / surgery*
  • Cerebral Ventricles / diagnostic imaging
  • Child
  • Child, Preschool
  • Decision Support Techniques*
  • Drainage / methods*
  • Female
  • Glasgow Coma Scale
  • Humans
  • Infant
  • Logistic Models
  • Male
  • Middle Aged
  • Minimally Invasive Surgical Procedures*
  • Neurosurgical Procedures / methods
  • Operative Time
  • Prognosis
  • Retrospective Studies
  • Severity of Illness Index
  • Tomography, X-Ray Computed
  • Trephining / methods*
  • Young Adult

Substances

  • Blood Glucose