Intracranial hemorrhage is a common complication for patients with cancer. Navi et al identified factors affecting prognosis in patients with both solid and hematologic malignancies. The authors are from Memorial Sloan-Kettering Cancer Center in New York City.
Outcome: 30-day mortality
Parameters:
(1) type of tumor
(2) level of consciousness
(3) number of foci of hemorrhage
(4) hydrocephalus
(5) ventriculostomy
(6) treatment for increased intracranial pressure (ICP)
|
Parameter |
Finding |
Points |
|
type of tumor |
primary brain |
0 |
|
|
other |
1 |
|
level of consciousness |
normal |
0 |
|
|
impaired |
1 |
|
number of foci of hemorrhage |
1 |
0 |
|
|
2 or more (multiple) |
1 |
|
hydrocephalus |
absent |
0 |
|
|
present |
1 |
|
ventriculostomy |
absent |
1 |
|
|
present |
0 |
|
treatment for increased ICP |
no |
0 |
|
|
yes |
1 |
where:
• Treatment for increased intracranial pressure can be interpreted in a number of ways. One is that untreated increased intracranial pressure is not a risk factor. The more likely is that anyone with increased intracranial pressure is treated because of the risk of tonsillar herniation.
• Neither anticoagulant nor antiplatelet drug use were significant predictors of mortality.
total number of poor prognostic factors =
= SUM(points for all 6 parameters)
Interpretation:
• minimum number of poor prognostic factors: 0
• maximum number of poor prognostic factors: 6
• The higher the number of poor prognostic factors the worse the prognosis.
• A patient with no or few poor prognostic factors may be a candidate for more aggressive management.
Specialty: Neurology
ICD-10: ,
