Validation and Optimization of Barrow Neurological Institute Score in Prediction of Adverse Events and Functional Outcome After Subarachnoid Hemorrhage-Creation of the HATCH (Hemorrhage, Age, Treatment, Clinical State, Hydrocephalus) Score.

Hostettler, Isabel Charlotte; Sebök, Martina; Ambler, Gareth; Muroi, Carl; Prömmel, Peter; Neidert, Marian Christoph; Richter, Johannes Konstantin; Pangalu, Athina; Regli, Luca; Germans, Menno Robbert (2020). Validation and Optimization of Barrow Neurological Institute Score in Prediction of Adverse Events and Functional Outcome After Subarachnoid Hemorrhage-Creation of the HATCH (Hemorrhage, Age, Treatment, Clinical State, Hydrocephalus) Score. Neurosurgery, 88(1), pp. 96-105. Oxford University Press 10.1093/neuros/nyaa316

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BACKGROUND

The Barrow Neurological Institute (BNI) score, measuring maximal thickness of aneurysmal subarachnoid hemorrhage (aSAH), has previously shown to predict symptomatic cerebral vasospasms (CVSs), delayed cerebral ischemia (DCI), and functional outcome.

OBJECTIVE

To validate the BNI score for prediction of above-mentioned variables and cerebral infarct and evaluate its improvement by integrating further variables which are available within the first 24 h after hemorrhage.

METHODS

We included patients from a single center. The BNI score for prediction of CVS, DCI, infarct, and functional outcome was validated in our cohort using measurements of calibration and discrimination (area under the curve [AUC]). We improved it by adding additional variables, creating a novel risk score (measure by the dichotomized Glasgow Outcome Scale) and validated it in a small independent cohort.

RESULTS

Of 646 patients, 41.5% developed symptomatic CVS, 22.9% DCI, 23.5% cerebral infarct, and 29% had an unfavorable outcome. The BNI score was associated with all outcome measurements. We improved functional outcome prediction accuracy by including age, BNI score, World Federation of Neurologic Surgeons, rebleeding, clipping, and hydrocephalus (AUC 0.84, 95% CI 0.8-0.87). Based on this model we created a risk score (HATCH-Hemorrhage, Age, Treatment, Clinical State, Hydrocephalus), ranging 0 to 13 points. We validated it in a small independent cohort. The validated score demonstrated very good discriminative ability (AUC 0.84 [95% CI 0.72-0.96]).

CONCLUSION

We developed the HATCH score, which is a moderate predictor of DCI, but excellent predictor of functional outcome at 1 yr after aSAH.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Radiology, Neuroradiology and Nuclear Medicine (DRNN) > Institute of Diagnostic, Interventional and Paediatric Radiology

UniBE Contributor:

Richter, Johannes Konstantin

Subjects:

600 Technology > 610 Medicine & health

ISSN:

1524-4040

Publisher:

Oxford University Press

Language:

English

Submitter:

Maria de Fatima Henriques Bernardo

Date Deposited:

14 Aug 2020 10:20

Last Modified:

05 Dec 2022 15:40

Publisher DOI:

10.1093/neuros/nyaa316

PubMed ID:

32779716

Uncontrolled Keywords:

Barrow neurological institute grade Delayed cerebral ischemia Outcome Prediction Subarachnoid hemorrhage

BORIS DOI:

10.7892/boris.145928

URI:

https://boris.unibe.ch/id/eprint/145928

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