Prediction of Neurological Deterioration After Intracerebral Hemorrhage: The SIGNALS Score
Background Intracerebral hemorrhage is the most disabling and lethal form of stroke. We aimed to develop a novel clinical score for neurological deterioration during hospitalization after intracerebral hemorrhage. Methods and Results We analyzed data from the CHERRY (Chinese Cerebral Hemorrhage: Mec...
| Main Authors: | , , , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2022-08-01
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| Series: | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| Subjects: | |
| Online Access: | https://www.ahajournals.org/doi/10.1161/JAHA.122.026379 |
| _version_ | 1797866354792988672 |
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| author | Quanwei He Hongxiu Guo Rentang Bi Shaoli Chen Jing Shen Chunnan Long Man Li Yuanpeng Xia Lei Zhang Zhou Sun Xiaolu Chen Zhaowei Wang Daokai Gong Jingwen Xu Dondya Zhu Yan Wan Bo Hu |
| author_facet | Quanwei He Hongxiu Guo Rentang Bi Shaoli Chen Jing Shen Chunnan Long Man Li Yuanpeng Xia Lei Zhang Zhou Sun Xiaolu Chen Zhaowei Wang Daokai Gong Jingwen Xu Dondya Zhu Yan Wan Bo Hu |
| author_sort | Quanwei He |
| collection | DOAJ |
| description | Background Intracerebral hemorrhage is the most disabling and lethal form of stroke. We aimed to develop a novel clinical score for neurological deterioration during hospitalization after intracerebral hemorrhage. Methods and Results We analyzed data from the CHERRY (Chinese Cerebral Hemorrhage: Mechanism and Intervention) study. Two‐thirds of eligible patients were randomly allocated into the training cohort (n=1027) and one‐third into the validation cohort (n=515). Multivariable logistic regression was used to identify factors associated with neurological deterioration (an increase in National Institutes of Health Stroke Scale of ≥4 or death) within 15 days after symptom onset. A prediction score was developed based on regression coefficients derived from the logistic model. The site, size, gender, National Institutes of Health Stroke Scale, age, leukocyte, sugar (SIGNALS) score was developed as a sum of individual points (0–8) based on site (1 point for infratentorial location), size (3 points for >20 mL of supratentorial hematoma volume or 2 points for >10 mL of infratentorial hematoma volume), sex (1 point for male sex), National Institutes of Health Stroke Scale score (1 point for >10), age (1 point for ≥70 years), white blood cell (1 point for>9.0×109/L), and fasting blood glucose (1 point>7.0 mmol/L). The proportion of patients who suffered from neurological deterioration increased with higher SIGNALS score, showing good discrimination and good calibration in the training cohort (C statistic, 0.821; Hosmer‐Lemeshow test, P=0.687) and in the validation cohort (C statistic, 0.848; Hosmer‐Lemeshow test, P=0.592), respectively. Conclusions The SIGNALS score reliably predicts the risk of in‐hospital neurological deterioration of patients with intracerebral hemorrhage. |
| first_indexed | 2024-04-09T23:23:57Z |
| format | Article |
| id | doaj.art-429d531f9e1645debe0d29c0870b1fe4 |
| institution | Directory Open Access Journal |
| issn | 2047-9980 |
| language | English |
| last_indexed | 2024-04-09T23:23:57Z |
| publishDate | 2022-08-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| spelling | doaj.art-429d531f9e1645debe0d29c0870b1fe42023-03-21T11:37:26ZengWileyJournal of the American Heart Association: Cardiovascular and Cerebrovascular Disease2047-99802022-08-01111510.1161/JAHA.122.026379Prediction of Neurological Deterioration After Intracerebral Hemorrhage: The SIGNALS ScoreQuanwei He0Hongxiu Guo1Rentang Bi2Shaoli Chen3Jing Shen4Chunnan Long5Man Li6Yuanpeng Xia7Lei Zhang8Zhou Sun9Xiaolu Chen10Zhaowei Wang11Daokai Gong12Jingwen Xu13Dondya Zhu14Yan Wan15Bo Hu16Department of Neurology, Union Hospital, Tongji Medical College Huazhong University of Science and Technology Wuhan Hubei Province ChinaDepartment of Neurology, Union Hospital, Tongji Medical College Huazhong University of Science and Technology Wuhan Hubei Province ChinaDepartment of Neurology, Union Hospital, Tongji Medical College Huazhong University of Science and Technology Wuhan Hubei Province ChinaDepartment of Neurology, Union Hospital, Tongji Medical College Huazhong University of Science and Technology Wuhan Hubei Province ChinaDepartment of Neurology, Union Hospital, Tongji Medical College Huazhong University of Science and Technology Wuhan Hubei Province ChinaDepartment of Neurology, Union Hospital, Tongji Medical College Huazhong University of Science and Technology Wuhan Hubei Province ChinaDepartment of Neurology, Union Hospital, Tongji Medical College Huazhong University of Science and Technology Wuhan Hubei Province ChinaDepartment of Neurology, Union Hospital, Tongji Medical College Huazhong University of Science and Technology Wuhan Hubei Province ChinaDepartment of Neurology, Union Hospital, Tongji Medical College Huazhong University of Science and Technology Wuhan Hubei Province ChinaDepartment of Neurology, Union Hospital, Tongji Medical College Huazhong University of Science and Technology Wuhan Hubei Province ChinaDepartment of Neurology, Union Hospital, Tongji Medical College Huazhong University of Science and Technology Wuhan Hubei Province ChinaDepartment of Neurology Qianjiang Central Hospital Qianjiang Hubei Province ChinaDepartment of Neurology Jingzhou Central Hospital Jingzhou Hubei Province ChinaDepartment of Neurology Honghu People’s Hospital Honghu Hubei Province ChinaSchool of Pharmacy Nanjing Medical University Nanjing Jiangsu Province ChinaDepartment of Neurology, Union Hospital, Tongji Medical College Huazhong University of Science and Technology Wuhan Hubei Province ChinaDepartment of Neurology, Union Hospital, Tongji Medical College Huazhong University of Science and Technology Wuhan Hubei Province ChinaBackground Intracerebral hemorrhage is the most disabling and lethal form of stroke. We aimed to develop a novel clinical score for neurological deterioration during hospitalization after intracerebral hemorrhage. Methods and Results We analyzed data from the CHERRY (Chinese Cerebral Hemorrhage: Mechanism and Intervention) study. Two‐thirds of eligible patients were randomly allocated into the training cohort (n=1027) and one‐third into the validation cohort (n=515). Multivariable logistic regression was used to identify factors associated with neurological deterioration (an increase in National Institutes of Health Stroke Scale of ≥4 or death) within 15 days after symptom onset. A prediction score was developed based on regression coefficients derived from the logistic model. The site, size, gender, National Institutes of Health Stroke Scale, age, leukocyte, sugar (SIGNALS) score was developed as a sum of individual points (0–8) based on site (1 point for infratentorial location), size (3 points for >20 mL of supratentorial hematoma volume or 2 points for >10 mL of infratentorial hematoma volume), sex (1 point for male sex), National Institutes of Health Stroke Scale score (1 point for >10), age (1 point for ≥70 years), white blood cell (1 point for>9.0×109/L), and fasting blood glucose (1 point>7.0 mmol/L). The proportion of patients who suffered from neurological deterioration increased with higher SIGNALS score, showing good discrimination and good calibration in the training cohort (C statistic, 0.821; Hosmer‐Lemeshow test, P=0.687) and in the validation cohort (C statistic, 0.848; Hosmer‐Lemeshow test, P=0.592), respectively. Conclusions The SIGNALS score reliably predicts the risk of in‐hospital neurological deterioration of patients with intracerebral hemorrhage.https://www.ahajournals.org/doi/10.1161/JAHA.122.026379intracerebral hemorrhageneurological deteriorationprognosisSIGNALS score |
| spellingShingle | Quanwei He Hongxiu Guo Rentang Bi Shaoli Chen Jing Shen Chunnan Long Man Li Yuanpeng Xia Lei Zhang Zhou Sun Xiaolu Chen Zhaowei Wang Daokai Gong Jingwen Xu Dondya Zhu Yan Wan Bo Hu Prediction of Neurological Deterioration After Intracerebral Hemorrhage: The SIGNALS Score Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease intracerebral hemorrhage neurological deterioration prognosis SIGNALS score |
| title | Prediction of Neurological Deterioration After Intracerebral Hemorrhage: The SIGNALS Score |
| title_full | Prediction of Neurological Deterioration After Intracerebral Hemorrhage: The SIGNALS Score |
| title_fullStr | Prediction of Neurological Deterioration After Intracerebral Hemorrhage: The SIGNALS Score |
| title_full_unstemmed | Prediction of Neurological Deterioration After Intracerebral Hemorrhage: The SIGNALS Score |
| title_short | Prediction of Neurological Deterioration After Intracerebral Hemorrhage: The SIGNALS Score |
| title_sort | prediction of neurological deterioration after intracerebral hemorrhage the signals score |
| topic | intracerebral hemorrhage neurological deterioration prognosis SIGNALS score |
| url | https://www.ahajournals.org/doi/10.1161/JAHA.122.026379 |
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