SIGNALS score for in-hospital Neurological deterioration in Intracerebral hemorrhage
In patients with intracerebral hemorrhage, the SIGNALS score is reliable in predicting the risk of in-hospital neurological deterioration as per a study published in the "Journal of the American Heart Association."
Intracerebral hemorrhage is the most devastating and lethal form of stroke that occurs due to traumatic or non-traumatic causes. Management varies from medical to surgical options. Researchers from China conducted a study to develop a novel clinical score for neurological deterioration during hospitalization after intracerebral hemorrhage. They used data from the CHERRY (Chinese Cerebral Hemorrhage: Mechanism and Intervention) study. Eligible patients were randomly allocated into two groups. Two‐thirds were placed in the training cohort with 1027 patients and one‐third in the validation cohort with 515 patients. To identify factors associated with neurological deterioration like an increase in the National Institutes of Health Stroke Scale of ≥4 or death within 15 days after symptom onset, Multivariable logistic regression was used. Based on the regression coefficients from the logistic model, a prediction score was developed.
The site, size, gender, National Institutes of Health Stroke Scale, age, leukocyte, and sugar (SIGNALS) score was developed as a sum of individual points of 0–8. The points were as follows, 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 |
Fasting blood glucose | 1 point>7.0 mmol/L |
Results:
The proportion of patients who suffered from neurological deterioration increased with higher SIGNALS scores, showing good discrimination and good calibration in the training cohort and the validation cohort.
Thus, the researchers concluded that the SIGNALS score reliably predicts the risk of in‐hospital neurological deterioration in patients with intracerebral hemorrhage.
For the full article, click here: https://doi.org/10.1161/JAHA.121.026379
He Q, Guo H, Bi R, et al. Prediction of Neurological Deterioration After Intracerebral Hemorrhage: The SIGNALS Score [published online ahead of print, 2022 Jul 20]. J Am Heart Assoc. 2022;e026379.
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