Clinical discriminators between acute brain hemorrhage and infarction

A practical score for early patient identification

Ayrton R. Massaro, Ralph L Sacco, Milberto Scaff, J. P. Mohr

Research output: Contribution to journalArticle

10 Citations (Scopus)

Abstract

New treatments for acute stroke require a rapid triage system, which minimizes treatment delays and maximizes selection of eligible patients. Our aim was to create a score for assessing the probability of brain hemorrhage among patients with acute stroke based upon clinical information. Of 1805 patients in the Stroke Data Bank, 1273 had infarction (INF) and 237 had parenchymatous hemorrhage (HEM) verified by CT. INF and HEM discriminators were determined by logistic regression and used to create a score. ROC curve was used to choose the cut-point for predicting HEM (score ≤ 2), with sensitivity of 76% and specificity of 83%. External validation was done using the NOMASS cohort. Although the use of a practical score by emergency personnel cannot replace the gold-standard brain image differentiation of HEM from INF for thrombolytic therapy, this score can help to select patients for stroke trials and pre-hospital treatments, alert CT scan technicians, and warn stroke teams of incoming patients to reduce treatment delays.

Original languageEnglish
Pages (from-to)185-191
Number of pages7
JournalArquivos de Neuro-Psiquiatria
Volume60
Issue number2 A
StatePublished - Jun 1 2002
Externally publishedYes

Fingerprint

Brain Infarction
Intracranial Hemorrhages
Stroke
Infarction
Hemorrhage
Triage
Thrombolytic Therapy
Therapeutics
ROC Curve
Gold
Patient Selection
Emergencies
Logistic Models
Databases
Sensitivity and Specificity
Brain

Keywords

  • Cerebral hemorrhage
  • Cerebral ischemia
  • Cerebrovascular disorders
  • Diagnosis
  • Stroke

ASJC Scopus subject areas

  • Psychiatry and Mental health
  • Neuroscience(all)

Cite this

Clinical discriminators between acute brain hemorrhage and infarction : A practical score for early patient identification. / Massaro, Ayrton R.; Sacco, Ralph L; Scaff, Milberto; Mohr, J. P.

In: Arquivos de Neuro-Psiquiatria, Vol. 60, No. 2 A, 01.06.2002, p. 185-191.

Research output: Contribution to journalArticle

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