ADVISING score: a reliable grading scale based on injury and response for intracerebral haemorrhage

Yan Wan, Department of Neurology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Hongxiu Guo, Department of Neurology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Shaoli Chen, Department of Neurology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Jiang Chang, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
David Wang, Neurovascular Division, Department of Neurology, Barrow Neurological Institute/Saint Joseph Hospital Medical Center, Phoenix, Arizona, USA.Follow
Rentang Bi, Department of Neurology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Man Li, Department of Neurology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Ke Shi, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Zhaowei Wang, Department of Neurology, Qianjiang Central Hospital, Qianjiang, Hubei, China.
Daokai Gong, Department of Neurology, Jingzhou Central Hospital, Jingzhou, Hubei, China.
Jingwen Xu, Department of Neurology, Honghu People's Hospital, Honghu, Hubei, China.
Quanwei He, Department of Neurology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China hubo@mail.hust.edu.cn hequanwei2008@126.com.
Bo Hu, Department of Neurology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China hubo@mail.hust.edu.cn hequanwei2008@126.com.

Document Type

Article

Abstract

BACKGROUND: Intracerebral haemorrhage (ICH) is the most devastating form of stroke causing high morbidity and mortality. We aimed to develop a novel clinical score incorporating multisystem markers to predict functional dependence at 90 days after ICH. METHODS: We analysed data from Chinese Cerebral Hemorrhage: Mechanism and Intervention study. Multivariable logistic regression analysis was used to identify the factors associated with 90-day functional dependency (the modified Rankin Scale ≥3) after ICH and develop the ADVISING scoring system. To test the scoring system, a total of 2111 patients from Hubei province were included as the training cohort, and 733 patients from other three provinces in China were included as an external validation cohort. RESULTS: We found nine variables to be significantly associated with functional dependency and included in the ADVISING score system: age, deep location of haematoma, volume of haematoma, National Institutes of Health Stroke Scale, aspartate transaminase, international normalised ratio, neutrophil-lymphocyte ratio, fasting blood glucose and glomerular filtration rate. Individuals were divided into 12 different categories by using these nine potential predictors. The proportion of patients who were functionally dependent increased with higher ADVISING scores, which showed good discrimination and calibration in both the training cohort (C-statistic, 0.866; p value of Hosmer-Lemeshow test, 0.195) and validation cohort (C-statistic, 0.884; p value of Hosmer-Lemeshow test, 0.853). The ADVISING score also showed better discriminative performance compared with the other five existing ICH scores (p<0.001). CONCLUSIONS: ADVISING score is a reliable tool to predict functional dependency at 90 days after ICH.

Medical Subject Headings

United States; Humans; Cerebral Hemorrhage; Stroke (complications); China; Hematoma (complications)

Publication Date

4-1-2023

Publication Title

Stroke and vascular neurology

E-ISSN

2059-8696

Volume

8

Issue

2

First Page

111

Last Page

118

PubMed ID

36137597

Digital Object Identifier (DOI)

10.1136/svn-2022-001707

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