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. 2022 Jul 29:13:915370.
doi: 10.3389/fneur.2022.915370. eCollection 2022.

Combining modified Graeb score and intracerebral hemorrhage score to predict poor outcome in patients with spontaneous intracerebral hemorrhage undergoing surgical treatment

Shen Wang  1 , Xuxu Xu  2 , Qiang Yu  3 , Haicheng Hu  3 , Chao Han  3 , Ruhai Wang  3
Affiliations

Combining modified Graeb score and intracerebral hemorrhage score to predict poor outcome in patients with spontaneous intracerebral hemorrhage undergoing surgical treatment

Shen Wang et al. Front Neurol. .

Abstract

Objective: Spontaneous intracerebral hemorrhage (sICH) is a frequently encountered neurosurgical disease. The purpose of this study was to evaluate the relationship between modified Graeb Score (mGS) at admission and clinical outcomes of sICH and to investigate whether the combination of ICH score could improve the accuracy of outcome prediction.

Methods: We retrospectively reviewed the medical records of 511 patients who underwent surgery for sICH between January 2017 and June 2021. Patient outcome was evaluated by the Glasgow Outcome Scale (GOS) score at 3 months following sICH, where a GOS score of 1-3 was defined as a poor prognosis. Univariate and multivariate logistic regression analyses were conducted to determine risk factors for unfavorable clinical outcomes. Receiver operating characteristic (ROC) curve analysis was performed to detect the optimal cutoff value of mGS for predicting clinical outcomes. An ICH score combining mGS was created, and the performance of the ICH score combining mGS was assessed for discriminative ability.

Results: Multivariate analysis demonstrated that a higher mGS score was an independent predictor for poor prognosis (odds ratio [OR] 1.207, 95% confidence interval [CI], 1.130-1.290, p < 0.001). In ROC analysis, an optimal cutoff value of mGS to predict the clinical outcome at 3 months after sICH was 11 (p < 0.001). An increasing ICH-mGS score was associated with increased poor functional outcome. Combining ICH score with mGS resulted in an area under the curve (AUC) of 0.790, p < 0.001.

Conclusion: mGS was an independent risk factor for poor outcome and it had an additive predictive value for outcome in patients with sICH. Compared with the ICH score and mGS alone, the ICH score combined with mGS revealed a significantly higher discriminative ability for predicting postoperative outcome.

Keywords: intracerebral hemorrhage score; modified Graeb score; outcome; spontaneous intracerebral hemorrhage; surgical treatment.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Receiver operating characteristic (ROC) curve of mGS score on the poor outcome of sICH.
Figure 2
Figure 2
Probability of poor functional outcome at 3 months for mGS.
Figure 3
Figure 3
Probability of poor functional outcome at 3 months for ICH-mGS score.
Figure 4
Figure 4
Receiver operating characteristic (ROC) curves of ICH score, ICH-mGS score on the poor outcome of sICH.
Figure 5
Figure 5
Receiver operating characteristic (ROC) curve of ICH-mGS score on the IVH growth.
See this image and copyright information in PMC

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