Up to you to figure out what this was for, I have no clue. But wonderful statistics.
A Delayed Modified Outperforms Baseline Scoring in Acute Intracerebral Hemorrhage
Abstract
The
Modified Intracerebral Hemorrhage (MICH) score is a simple tool created
to provide prognostication in basal ganglia hemorrhages. Current
prognostic scores, including the MICH, are based on the assessment of
baseline patient characteristics, failing to account for significant
developments, such as intraventricular extension and clinical
deterioration, which may occur over the first 72 hours. We propose to
validate the MICH in all hemorrhage locations and hypothesize that its
calculation at 72 hours will outperform its baseline counterpart with
respect to predicting mortality and functional outcome. We performed a
retrospective analysis of collated data from the Virtual International
Stroke Trials Archive database. Primary outcome was 90-day mortality.
Secondary outcome was poor outcome (modified Rankin Scale 4-6) at 90
days. Receiver operating characteristic curves were generated looking at
the predictive ability of the MICH score for mortality and poor
outcome, at baseline and at 72 hours. Competing curves were assessed
with nonparametric methods. A total of 226 patients were included, with a
90-day mortality of 22.5%. The MICH scores calculated at 72 hours were
more predictive of mortality than at baseline (area under the curve
[AUC]: 0.89 [95% confidence interval [CI]: 0.83-0.94] vs 0.78 [95% CI:
0.70-0.85]), P < .01. The MICH scores at 72 hours similarly
better predicted functional outcome (AUC: 0.78 [95% CI: 0.72-0.84] vs
AUC: 0.72 [95% CI: 0.66-0.78]), P = .047. The MICH score has
positive prognostic value for mortality and poor functional outcome in
all hemorrhage locations. Delaying its calculation resulted in higher
predictive values for both and suggests that delaying discussions around
withdrawal of care may result in more accurate prognostication in acute
intracerebral hemorrhage.
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