Morotti et al reported a simple score for predicting hematoma expansion for a patient with intracerebral hemorrhage based on findings seen in non-contrast tomography. The authors are from multiple institutions in North America and Europe.
Patient selection: intracerebral hemorrhage (ICH)
Outcome: expansion of hematoma (> 6 mL or >33%)
Parameters:
(1) blend sign (B) an area of hypoattenuation next to the hyperattenuation of the hematoma, with sharp separation between the 2 areas and a density difference >= 18 HU
(2) any hypodensity (A) within the hematoma
(3) time from onset to noncontrast CT (T)
Parameter
Finding
Points
blend sign
absent
0
present
1
any hypodensity
absent
0
present
2
time to CT scan
< 2.5 hours
2
>= 2.5 hours
0
total score =
= SUM(points for all 3 parameters)
Interpretation:
• minimum score: 0
• maximum score: 5
• The higher the score the greater the risk of hematoma expansion.
• A score >= 3 predicted hematoma expansion with a sensitivity of 50% and specificity of 89%.
Score
Development Cohort
Validation Cohorts
0 or 1
7%
7-10%
2
19%
21%
3
46%
32-47%
4
51%
40%
5
75%
53-59%
Performance:
• The area under the ROC curve is 0.77 in the development set.
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