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

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.

Basic information

Original name

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

Authors

KLAAS, J.P. (840 United States of America), S. BRAKSICK (840 United States of America), J. MANDREKAR (840 United States of America), Petra ŠEDOVÁ (203 Czech Republic, guarantor, belonging to the institution), M.F. BELLOLIO (840 United States of America), A.A. RABINSTEIN (840 United States of America) and R.D. Jr. BROWN (840 United States of America)

Edition

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

Other information

Language

English

Type of outcome

Článek v odborném periodiku

Field of Study

30218 General and internal medicine

Country of publisher

United States of America

Confidentiality degree

není předmětem státního či obchodního tajemství

Impact factor

Impact factor: 3.163

RIV identification code

RIV/00216224:14110/17:00096138

Organization unit

Faculty of Medicine

DOI

http://dx.doi.org/10.1007/s12028-016-0346-7

UT WoS

000406310200011

Keywords in English

Intensive care; Intracerebral hemorrhage; Triage

Abstract

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.

Citovat

KLAAS, J.P., S. BRAKSICK, J. MANDREKAR, Petra ŠEDOVÁ, M.F. BELLOLIO, A.A. RABINSTEIN and R.D. Jr. BROWN. Factors Associated with the Need for Intensive Care Unit Admission Following Supratentorial Intracerebral Hemorrhage: The Triage ICH Model. Neurocritical Care. Totowa: Humana Press, 2017, vol. 27, No 1, p. 75-81. ISSN 1541-6933. Available from: https://dx.doi.org/10.1007/s12028-016-0346-7.

@article{1372046,
   author = {Klaas, J.P. and Braksick, S. and Mandrekar, J. and Šedová, Petra and Bellolio, M.F. and Rabinstein, A.A. and Brown, R.D. Jr.},
   article_location = {Totowa},
   article_number = {1},
   doi = {http://dx.doi.org/10.1007/s12028-016-0346-7},
   keywords = {Intensive care; Intracerebral hemorrhage; Triage},
   language = {eng},
   issn = {1541-6933},
   journal = {Neurocritical Care},
   title = {Factors Associated with the Need for Intensive Care Unit Admission Following Supratentorial Intracerebral Hemorrhage: The Triage ICH Model.},
   volume = {27},
   year = {2017}
}

TY  - JOUR
ID  - 1372046
AU  - Klaas, J.P. - Braksick, S. - Mandrekar, J. - Šedová, Petra - Bellolio, M.F. - Rabinstein, A.A. - Brown, R.D. Jr.
PY  - 2017
TI  - Factors Associated with the Need for Intensive Care Unit Admission Following Supratentorial Intracerebral Hemorrhage: The Triage ICH Model.
JF  - Neurocritical Care
VL  - 27
IS  - 1
SP  - 75-81
EP  - 75-81
PB  - Humana Press
SN  - 15416933
KW  - Intensive care
KW  - Intracerebral hemorrhage
KW  - Triage
N2  - 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.
ER  -

KLAAS, J.P., S. BRAKSICK, J. MANDREKAR, Petra ŠEDOVÁ, M.F. BELLOLIO, A.A. RABINSTEIN and R.D. Jr. BROWN. Factors Associated with the Need for Intensive Care Unit Admission Following Supratentorial Intracerebral Hemorrhage: The Triage ICH Model. \textit{Neurocritical Care}. Totowa: Humana Press, 2017, vol.~27, No~1, p.~75-81. ISSN~1541-6933. Available from: https://dx.doi.org/10.1007/s12028-016-0346-7.

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