J 2017

Factors Associated with the Need for Intensive Care Unit Admission Following Supratentorial Intracerebral Hemorrhage: The Triage ICH Model.

KLAAS, J.P., S. BRAKSICK, J. MANDREKAR, Petra ŠEDOVÁ, M.F. BELLOLIO et. al.

Základní údaje

Originální název

Factors Associated with the Need for Intensive Care Unit Admission Following Supratentorial Intracerebral Hemorrhage: The Triage ICH Model.

Autoři

KLAAS, J.P. (840 Spojené státy), S. BRAKSICK (840 Spojené státy), J. MANDREKAR (840 Spojené státy), Petra ŠEDOVÁ (203 Česká republika, garant, domácí), M.F. BELLOLIO (840 Spojené státy), A.A. RABINSTEIN (840 Spojené státy) a R.D. Jr. BROWN (840 Spojené státy)

Vydání

Neurocritical Care, Totowa, Humana Press, 2017, 1541-6933

Další údaje

Jazyk

angličtina

Typ výsledku

Článek v odborném periodiku

Obor

30218 General and internal medicine

Stát vydavatele

Spojené státy

Utajení

není předmětem státního či obchodního tajemství

Impakt faktor

Impact factor: 3.163

Kód RIV

RIV/00216224:14110/17:00096138

Organizační jednotka

Lékařská fakulta

UT WoS

000406310200011

Klíčová slova anglicky

Intensive care; Intracerebral hemorrhage; Triage

Štítky

Příznaky

Mezinárodní význam, Recenzováno
Změněno: 20. 3. 2018 17:18, Soňa Böhmová

Anotace

V originále

Abstract BACKGROUND: Providing the correct level of care for patients with intracerebral hemorrhage (ICH) is crucial, but the level of care needed at initial presentation may not be clear. This study evaluated factors associated with admission to intensive care unit (ICU) level of care. METHODS: This is an observational study of all adult patients admitted to our institution with non-traumatic supratentorial ICH presenting within 72 h of symptom onset between 2009-2012 (derivation cohort) and 2005-2008 (validation cohort). Factors associated with neuroscience ICU admission were identified via logistic regression analysis, from which a triage model was derived, refined, and retrospectively validated. RESULTS: For the derivation cohort, 229 patients were included, of whom 70 patients (31 %) required ICU care. Predictors of neuroscience ICU admission were: younger age [odds ratio (OR) 0.94, 95 % CI 0.91-0.97; p = 0.0004], lower Full Outline of UnResponsiveness (FOUR) score (0.39, 0.28-0.54; p < 0.0001) or Glasgow Coma Scale (GCS) score (0.55, 0.45-0.67; p < 0.0001), and larger ICH volume (1.04, 1.03-1.06; p < 0.0001). The model was further refined with clinician input and the addition of intraventricular hemorrhage (IVH). GCS was chosen for the model rather than the FOUR score as it is more widely used. The proposed triage ICH model utilizes three variables: ICH volume 30 cc, GCS score <13, and IVH. The triage ICH model predicted the need for ICU admission with a sensitivity of 94.3 % in the derivation cohort [area under the curve (AUC) = 0.88; p < 0.001] and 97.8 % (AUC = 0.88) in the validation cohort. CONCLUSIONS: Presented are the derivation, refinement, and validation of the triage ICH model. This model requires prospective validation, but may be a useful tool to aid clinicians in determining the appropriate level of care at the time of initial presentation for a patient with a supratentorial ICH.