Degos et al reported the Admission Bioclinical (ABC) score for evaluating a patient following coiling of a cerebral artery aneurysm. This can help to predict the clinical outcome at 1 year. The authors are from Universite Pierre et Marie Curie in Paris and University of California at San Francisco.
Patient selection: aneurysm coiling following subarachnoid hemorrhage
Outcome: mortality at 1-year
Parameters:
(1) Glasgow coma score (GCS) on admission
(2) serum troponin I on admission in µg/L (Stratus, Dade)
(3) serum S100-beta in µg/L (Byk-Sangtec France Laboratories)
Parameter |
Finding |
Points |
Glasgow coma score |
15 |
0 |
|
14 |
1 |
|
13 |
2 |
|
3 to 12 |
3 |
serum troponin I |
low (<= 0.5 µg/L) |
0 |
|
high (> 0.5 µg/L) |
1 |
serum S100-beta |
low (<= 0.5 µg/L) |
0 |
|
high (> 0.5 µg/L) |
2 |
where:
• The cutoff for troponin I and S100-beta correspond to 5 times the upper limit of normal (ULN).
total score =
= SUM(points for all 3 parameters)
Interpretation:
• minimum score: 0
• maximum score: 6
• The higher the score the worse the prognosis.
Performance:
• The area under the ROC curve was 0.82 in the derivation set and 0.76 in the validation set.
• A score >= 2 had the same Youden index as a score >= 3.
• A score >= 2 had a sensitivity of 86% and specificity of 65%, with expected 1-year mortality >= 15%.
• A score >= 3 had a sensitivity of 73% and specificity of 78%, with expected 1-year mortality >= 25%.
Specialty: Neurology