Accuracy of the ABC/2 Score for Intracerebral Hemorrhage Systematic Review and Analysis of MISTIE, CLEAR-IVH, and CLEAR III

被引：143

作者：

Webb, Alastair J. S. ^{[1
]}

Ullman, Natalie L. ^{[2
]}

Morgan, Tim C. ^{[2
]}

Muschelli, John ^{[3
]}

Kornbluth, Joshua ^{[2
]}

Awad, Issam A. ^{[4
]}

Mayo, Stephen ^{[5
]}

Rosenblum, Michael ^{[3
]}

Ziai, Wendy ^{[2
]}

Zuccarrello, Mario ^{[6
]}

Aldrich, Francois ^{[7
]}

John, Sayona ^{[8
]}

Harnof, Sagi ^{[9
]}

Lopez, George ^{[8
]}

Broaddus, William C. ^{[10
]}

Wijman, Christine ^{[11
]}

Vespa, Paul ^{[12
]}

Bullock, Ross ^{[10
]}

Haines, Stephen J. ^{[13
]}

Cruz-Flores, Salvador ^{[14
]}

Tuhrim, Stan ^{[15
]}

Hill, Michael D. ^{[16
]}

Narayan, Raj ^{[17
]}

Hanley, Daniel F. ^{[2
]}

机构：

[1] Univ Oxford, Dept Clin Neurosci, Oxford, England

[2] Johns Hopkins Med Inst, Div Brain Injury Outcomes, Baltimore, MD 21205 USA

[3] Johns Hopkins Bloomberg Sch Publ Hlth, Dept Biostat, Baltimore, MD USA

[4] Univ Chicago, Dept Neurosurg, Chicago, IL 60637 USA

[5] Emissary Int LLC, Austin, TX USA

[6] Univ Cincinnati, Dept Neurosurg, Cincinnati, OH 45221 USA

[7] Univ Maryland, Dept Neurosurg, Baltimore, MD 21201 USA

[8] Rush Univ, Med Ctr, Dept Neurol, Chicago, IL 60612 USA

[9] Chaim Sheba Med Ctr, Dept Neurosurg, Ramat Gan, Israel

[10] Virginia Commonwealth Univ Med Coll Virginia, Dept Neurosurg, Richmond, VA USA

[11] Stanford Med, Dept Neurol & Neurol Sci, Stanford, CA USA

[12] Univ Calif Los Angeles, Dept Neurosurg, Los Angeles, CA USA

[13] Med Univ S Carolina, Dept Neurol Surg, Charleston, SC USA

[14] St Louis Univ, St Louis, MO 63103 USA

[15] Mt Sinai Sch Med, Dept Neurol, New York, NY USA

[16] Univ Calgary, Dept Clin Neurosci, Calgary, AB T2N 1N4, Canada

[17] Wayne State Univ, Dept Neurosurg, Detroit, MI USA

来源：

STROKE | 2015年 / 46卷 / 09期

基金：

美国国家卫生研究院;

关键词：

cerebral hemorrhage; controlled clinical trials; randomized; review; systematic; sensitivity and specificity; tissue-type plasminogen activator; MINIMALLY-INVASIVE SURGERY; INITIAL CONSERVATIVE TREATMENT; ASSISTED VOLUMETRIC-ANALYSIS; HEMATOMA VOLUME; RANDOMIZED-TRIAL; CLINICAL-TRIAL; WARFARIN; MULTICENTER; STICH; SHAPE;

D O I：

10.1161/STROKEAHA.114.007343

中图分类号：

R74 [神经病学与精神病学];

学科分类号：

摘要：

Background and Purpose-The ABC/2 score estimates intracerebral hemorrhage (ICH) volume, yet validations have been limited by small samples and inappropriate outcome measures. We determined accuracy of the ABC/2 score calculated at a specialized reading center (RC-ABC) or local site (site-ABC) versus the reference-standard computed tomography-based planimetry (CTP). Methods-In Minimally Invasive Surgery Plus Recombinant Tissue-Type Plasminogen Activator for Intracerebral Hemorrhage Evacuation-II (MISTIE-II), Clot Lysis Evaluation of Accelerated Resolution of Intraventricular Hemorrhage (CLEAR-IVH) and CLEAR-III trials. ICH volume was prospectively calculated by CTP, RC-ABC, and site-ABC. Agreement between CTP and ABC/2 was defined as an absolute difference up to 5 mL and relative difference within 20%. Determinants of ABC/2 accuracy were assessed by logistic regression. Results-In 4369 scans from 507 patients, CTP was more strongly correlated with RC-ABC (r(2)=0.93) than with site-ABC (r(2)=0.87). Although RC-ABC overestimated CTP-based volume on average (RC-ABC, 15.2 cm(3); CTP, 12.7 cm(3)), agreement was reasonable when categorized into mild, moderate, and severe ICH (kappa=0.75; P<0.001). This was consistent with overestimation of ICH volume in 6 of 8 previous studies. Agreement with CTP was greater for RC-ABC (84% within 5 mL; 48% of scans within 20%) than for site-ABC (81% within 5 mL; 41% within 20%). RC-ABC had moderate accuracy for detecting >= 5 mL change in CTP volume between consecutive scans (sensitivity, 0.76; specificity, 0.86) and was more accurate with smaller ICH, thalamic hemorrhage, and homogeneous clots. Conclusions-ABC/2 scores at local or central sites are sufficiently accurate to categorize ICH volume and assess eligibility for the CLEAR-III and MISTIE III studies and moderately accurate for change in ICH volume. However, accuracy decreases with large, irregular, or lobar clots.

引用

页码：2470 / 2476

页数：7

共 24 条

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