Yao et al reported the HEP (hematoma expansion prediction) score for a patient with acute intracerebral hematoma (ICH). This can help to identify a patient who may require more aggressive management. The authors are from Shanghai Jiao Tong University, Harvard University, Beth Israel Deaconess Medical Center and Sichuan University.
Patient selection: acute stroke with intracerebral hemorrhage
Outcome: substantial hematoma expansion (SHE)
Parameters:
(1) time from ICH onset to baseline CT in hours
(2) diagnosis of dementia
(3) current smoking
(4) antiplatelet drug use
(5) Glasgow coma scale (GCS) at presentation
(6) subarachnoid hemorrhage (SAH) on baseline CT
Parameter
Finding
Points
time from ICH onset
>= 3 hours
0
< 3 hours
3
dementia
no
0
yes
4
current smoking
no
0
yes
3
antiplatelet drug use
no
0
yes
3
GCS
3-5
3
6-8
2
9-11
1
12-15
0
SAH on baseline CT
no
0
yes
2
total score =
= SUM(points for all of the parameters)
Interpretation:
• minimum score: 0
• maximum score: 18
• The higher the score the greater the risk of substantial hematoma expansion.
• Substantial hematoma expansion is associated with neurological deterioration and death.
Total Score
Risk of Substantial Hematoma Expansion
0
9%
1
21%
2
42%
3
66%
4
84%
5
94%
6
98%
>= 7
>= 99%
Performance:
• The area under the ROC curve is 0.76.
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