Abstract Details

Title A Novel Score for Stratifying Risk of Critical Care Needs in Intracerebral Hemorrhage Patients

Topic Cerebrovascular Disease and Interventional Neurology

Presentation(s) Cerebrovascular Disease and Interventional Neurology Posters (7:00 AM-5:00 PM)

Poster/Presentation
Number 078

Objective

To develop a risk prediction score identifying intracerebral hemorrhage (ICH) patients at low risk for critical care interventions.

Background

ICH patients are typically admitted to the intensive care unit (ICU); however, not all ICH patients require critical care interventions. We developed a risk prediction score for critical care needs after ICH in order to identify a subpopulation of ICH patients who may safely forgo ICU admission.

Design/Methods We retrospectively analyzed data of 451 ICH patients between 2010-2018 and randomly divided them into a development and a validation cohort. Logistic regression was used to develop the risk score by weighting independent predictors of ICU needs based on strength of association. The risk score was tested in the validation cohort, and externally validated with another institution’s dataset.

Results The rate of ICU interventions was 80.3%. Systolic blood pressure (SBP), Glasgow Coma Scale (GCS), intraventricular hemorrhage (IVH), and ICH volume were independent predictors of critical care, resulting in the following point assignments for the INtensive care TRiaging IN Spontaneous IntraCerebral hemorrhage (INTRINSIC) score: SBP 160-190 mm Hg (1 point), SBP >190 mm Hg (3 points); GCS 8-13 (1 point), GCS <8 (3 points); ICH volume 16- 40 cm³ (1 point), ICH volume >40 cm³ (2 points); and presence of IVH (1 point), with values ranging between 0-9. The INTRINSIC score achieved an AUC of 0.880 (95% CI 0.833-0.928) in the validation cohort. A score <2 predicted absence of critical care needs with 65.2% sensitivity and 89.2% specificity, and a score <3 predicted absence of critical care needs with 86.5% sensitivity and 79.8% specificity. Among patients with a score of 0 and no ICU needs during their emergency department stay, 93.6% remained without critical care needs.

Conclusions The INTRINSIC score identifies ICH patients at low risk for critical care interventions.

Authors/Disclosures
Bridget J. Chen (Johns Hopkins University) PRESENTER	Miss Chen has nothing to disclose.
	No disclosure on file
Elisabeth B. Marsh, MD, F�鶹��ýӳ�� (Johns Hopkins School of Medicine)	Dr. Marsh has received personal compensation in the range of $0-$499 for serving as an officer or member of the Board of Directors for �鶹��ýӳ��. Dr. Marsh has received personal compensation in the range of $0-$499 for serving as an officer or member of the Board of Directors for American Neurological Association. Dr. Marsh has received personal compensation in the range of $0-$499 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Stroke. Dr. Marsh has received personal compensation in the range of $5,000-$9,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for ACTN. The institution of Dr. Marsh has received research support from American Heart Association. The institution of Dr. Marsh has received research support from National Institutes of Health. The institution of Dr. Marsh has received research support from National Institutes of Health.
Ayham M. Alkhachroum, MD (Columbia University Medical Center)	The institution of Dr. Alkhachroum has received research support from Miami CTSI.
Wei Xiong, MD (University Hospitals)	Dr. Xiong has nothing to disclose.
Victor C. Urrutia, MD (Johns Hopkins University School of Medicine)	Dr. Urrutia has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Genentech, Inc. The institution of Dr. Urrutia has received research support from Genentech, Inc. The institution of Dr. Urrutia has received research support from Genentech, Inc. Dr. Urrutia has received personal compensation in the range of $5,000-$9,999 for serving as a Medical Director of CME course with PeerView.
Rebecca F. Gottesman, MD, PhD (Johns Hopkins University)	The institution of Dr. Gottesman has received research support from NIH.
Romanus R. Faigle, MD, PhD (Sarasota Memorial Hospital)	Dr. Faigle has received personal compensation in the range of $10,000-$49,999 for serving as an Expert Witness for several law firms. The institution of Dr. Faigle has received research support from The Morninstar Foundation.

�鶹��ýӳ��

�鶹��ýӳ��