Misra et al evaluated factors associated with recovery following a supratentorial intracerebral hemorrhage. This can help separate patients into groups based on expected recovery at 3 months. The authors are from Gandhi Postgraduate Institute of Medical Sciences in Lucknow, India.
Exclusions: aneurysmal bleeds, arteriovenous malformations (AVM), tumor bleed, anticoagulant-related hemorrhage
Outcome was based on the Barthel Index at 3 months, with index >= 12 defined as good and < 12 as poor.
Parameters identified on logistic regression analysis:
(1) Glasgow coma score (GCS)
(2) Canadian Neurological Scale score (CNSS, with high score good)
(3) reflexes
(4) ventricular extension of hemorrhage
(5) motor evoked potentials (MEP; electrical stimulation is performed on the motor cortex and the spinous process of several cervical vertebrae; inexcitability is considered abnormal)
|
Parameter |
Finding |
Points |
|
Glasgow coma score |
< 6 |
1 |
|
|
6 - 12 |
2 |
|
|
> 12 |
3 |
|
Canadian Neurological Scale score |
< 3.5 |
1 |
|
|
3.5 - 7.0 |
2 |
|
|
> 7.0 |
3 |
|
reflexes |
hypo |
1 |
|
|
hyper |
2 |
|
|
normal |
3 |
|
ventricular extension of hemorrhage |
present |
1 |
|
|
absent |
2 |
|
motor evoked potentials |
unrecordable |
1 |
|
|
recordable |
2 |
X =
= (-2.07 * (points for GCS)) + (1.01 * (points of CNSS)) + (1.36 * (points for reflex)) + (3.30 * (points for ventricular extension)) + (2.47 * (points for MEPS)) - 9.31
probability of recovery =
= 1 / (1 + EXP((-1) * X))
where:
• I am not sure why the coefficient for GCS is a negative value. When different values are tried in the formula, higher GCS are associated with a lower good recovery rate than a lower GCS, which is the opposite of the data in Table 2. However, if the a positive coefficient is used, the formula does not function well.
Specialty: Neurology
ICD-10: ,
