THE INITIAL FULL OUTLINE OF UNRESPONSIVNESS SCORE AS THE PREDICTOR OF CLINICAL OUTCOME IN ACUTE INTRACEREBRAL HEMORRHAGE WITHIN 30 DAYS OF ONSET
DOI:
https://doi.org/10.61841/4n441v08Keywords:
FOUR Score, Intracerebral hemorrhage (IH), Predictor of clinical outcomes, consiousnessAbstract
Background: Intracerebral hemorrhage (IH) is the most leading cause of death and disability due to the inavaibility of adequate therapy, thus regarded as an emergency medical condition to determine the prognosis in patients with IH.
Objective: To introduce the Initial Full Outline of Unresponsiveness FOUR score as a clinical scale alternative used in patients with IH with or without loss of consciousness.
Methods: The prospective cohort study was conducted in 64 patients with acute IH who visited the emergency unit of Dr. Soetomo Teaching Hospital. It was a clinical neurological test, laboratory test, and head CT scan without contrast. Four scale measurements were conducted during the first visit and its clinical outcomes with the Glasgow Outcome Scale (GOS) within 30 days of onset. A Chi Square test was conducted to discern the correlation between the initial FOUR score and clinical outcomes within 30 days of intracerebral hemorrhage onset.
Results: There was a significant correlation between the variables of the FOUR score and clinical outcomes in patients with intracerebral hemorrhage, with a p value of 0.000 (<0.05). The value of odds ratio (OR) was 36.00 (95% CI 4.378-296.016), which meant the patients with a lower FOUR score had the possibility of obtaining 36 times worse clinical outcomes than patients with a higher FOUR score.
Conclusion: There was a correlation between the initial FOUR score and clinical outcomes of acute intracerebral hemorrhage within 30 days of onset.
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[1] Ferrete-Araujo AM, Egea-Guerrero JJ, Vilches-Arenas Á, Godoy DA, Murillo-Cabezas F. Predictors of mortality and poor functional outcome in severe spontaneous intracerebral hemorrhage: a prospective observational study. Med Intensiva (English Ed. 2015;39(7):422-42).
[2] Rost NS, Smith EE, Chang Y, Snider RW, Chanderraj R, Schwab K, et al. Prediction of functional outcome in patients with primary intracerebral hemorrhage: the FUNC score. Stroke. 2008;39(8):2304–9.
[3] Morgenstern LB, Hemphill III JC, Anderson C, Becker K, Broderick JP, Connolly Jr. ES, et al. Guidelines for the management of spontaneous intracerebral hemorrhage: a guideline for healthcare professionals from the American Heart Association/American Stroke Association. Stroke. 2010;41(9):2108–29.
[4] Shi Q, Presutti R, Selchen D, Saposnik G. Delirium in acute stroke: a systematic review and meta-analysis. Stroke. 2012;43(3):645–9.
[5] Al Fauzi A, Sumorejo P, Suroto NS, Parenrengi MA, Wahyuhadi J, Turchan A, et al. Clinical Outcomes of Repeated Intraventricular Transplantation of Autologous Bone Marrow Mesenchymal Stem Cells in Chronic Hemorrhagic Stroke. A One-Year Follow-Up. Open Neurol J. 2017;11:74.
[6] Rahma ON, Wijaya SK, Prawito, Badri C. Electroencephalogram analysis with an extreme learning machine as a supporting tool for classifying acute ischemic stroke severity. In Biomedical Engineering, Department of Physic, Universitas Airlangga, Surabaya, Indonesia: Institute of Electrical and Electronics Engineers Inc.; 2017. p. 180–6. Available from: https://www.scopus.com/inward/record.uri?eid=2-s2.0-
85043448686&doi=10.1109%2FISSIMM.2017.8124287&partnerID=40&md5=06a92fcd6d08db9d56bb4778c45731cb
[7] Adrianto Y, Susilo H. COMPARISON OF FUNCTIONAL IMPROVEMENT SCALE (NIHSS) DEGREE BETWEEN ACUTE INTRACEREBRAL HEMORRHAGE STROKE PATIENTS RECEIVING STANDARD TREATMENT AND THOSE RECEIVING STANDARD TREATMENT PLUS
CELECOXIB. Folia Medica Indones. 2014;50(4):234.
[8] Amaheka BJ, Machfoed MH, Putra ST. Examination of OXLDL Serum Level as the Prognosis of Acute Thrombotic Ischemic Stroke. Folia Medica Indones. 2007;43(1):23–7.
[9] Clarke JL, Johnston SC, Farrant M, Bernstein R, Tong D, Hemphill JC. External validation of the ICH score. Neurocrit Care. 2004;1(1):53–60.
[10] Wijdicks EFM, Bamlet WR, Maramattom B V, Manno EM, McClelland RL. Validation of a new coma scale: the FOUR score. Ann Neurol Off J Am Neurol Assoc Child Neurol Soc. 2005;58(4):585–93.
[11] Kocak Y, Ozturk S, Ege F, Ekmekci AH. A useful new coma scale in acute stroke patients: FOUR score. Anaesth Intensive Care. 2012;40(1):131–6.
[12] Stead LG, Wijdicks EFM, Bhagra A, Kashyap R, Bellolio MF, Nash DL, et al. Validation of a new coma scale, the FOUR score, in the emergency department. Neurocrit Care. 2009;10(1):50.
[13] Saika A, Bansal S, Philip M, Devi BI, Shukla DP. Prognostic value of FOUR and GCS scores in determining mortality in patients with traumatic brain injury. Acta Neurochir (Wien). 2015;157(8):1323–8.
[14] Idrovo L, Fuentes B, Medina J, Gabaldón L, Ruiz-Ares G, Abenza MJ, et al. Validation of the FOUR Score (Spanish Version) in acute stroke: an interobserver variability study. Eur Neurol. 2010;63(6):364–9.
[15] Weir J, Steyerberg EW, Butcher I, Lu J, Lingsma HF, McHugh GS, et al. Does the extended Glasgow Outcome Scale add value to the conventional Glasgow Outcome Scale? J Neurotrauma. 2012;29(1):53–8.
[16] An SJ, Kim TJ, Yoon B-W. Epidemiology, risk factors, and clinical features of intracerebral hemorrhage: an update. J stroke. 2017;19(1):3.
[17] Hemphill JC, Bonovich DC, Besmertis L, Manley GT, Johnston SC. The ICH score. Stroke. 2001;32(4):891–7.
[18] Caplan LR. Caplan’s stroke. Cambridge University Press; 2016.
[19] Azzimondi G, Bassein L, Nonino F, Fiorani L, Vignatelli L, Re G, et al. Fever in acute stroke worsens prognosis: a prospective study. Stroke. 1995;26(11):2040–3.
[20] Schlunk F, Greenberg SM. The pathophysiology of intracerebral hemorrhage formation and expansion. Transl Stroke Res. 2015;6(4):257–63.
[21] Aguilar MI, Brott TG. Update in intracerebral hemorrhage. The Neurohospitalist. 2011;1(3):148–59.
[22] Gupta M, Verma R, Parihar A, Garg RK, Singh MK, Malhotra HS. Perihematomal edema as a predictor of outcome in spontaneous intracerebral hemorrhage. J Neurosci Rural Pract. 2014;5(1):48.
[23] Kimura K, Iguchi Y, Inoue T, Shibazaki K, Matsumoto N, Kobayashi K, et al. Hyperglycemia independently increases the risk of early death in acute spontaneous intracerebral hemorrhage. J Neurol Sci. 2007;255(1–2):90–4.
[24] Song E-C, Chu K, Jeong S-W, Jung K-H, Kim S-H, Kim M, et al. Hyperglycemia exacerbates brain edema and perihematomal cell death after intracerebral hemorrhage. Stroke. 2003;34(9):2215–20.
[25] Bhattathiri PS, Gregson B, Prasad KSM, Mendelow AD. Intraventricular hemorrhage and hydrocephalus after spontaneous intracerebral hemorrhage: results from the STICH trial. In: Brain Edema XIII. Springer; 2006. p. 65–8.
[26] Diringer MN, Edwards DF, Zazulia AR. Hydrocephalus: a previously unrecognized predictor of poor outcome from supratentorial intracerebral hemorrhage. Stroke. 1998;29(7):1352–7.
[27] Phan TG, Koh M, Vierkant RA, Wijdicks EFM. Hydrocephalus is a determinant of early mortality in putaminal hemorrhage. Stroke. 2000;31(9):2157–62.
[28] Liliang P-C, Liang C-L, Lu C-H, Chang H-W, Cheng C-H, Lee T-C, et al. Hypertensive caudate hemorrhage prognostic predictor, outcome, and role of external ventricular drainage. Stroke. 2001;32(5):1195–200.
[29] Szepesi R, Széll IK, Hortobágyi T, Kardos L, Nagy K, Lánczi LI, et al. New prognostic score for the prediction of 30-day outcome in spontaneous supratentorial cerebral haemorrhage. Biomed Res Int. 2015;2015.
[30] Vespa PM, O’phelan K, Shah M, Mirabelli J, Starkman S, Kidwell C, et al. Acute seizures after intracerebral hemorrhage: a factor in progressive midline shift and outcome. Neurology. 2003;60(9):1441–6.
[31] Haapaniemi E, Strbian D, Rossi C, Putaala J, Sipi T, Mustanoja S, et al. The CAVE score for predicting late seizures after intracerebral hemorrhage. Stroke. 2014;45(7):1971–6.
[32] Nilsson OG, Lindgren A, Brandt L, Säveland H. Prediction of death in patients with primary intracerebral hemorrhage: a prospective study of a defined population. J Neurosurg. 2002;97(3):531-6.
[33] Mittal MK, Lele A. Predictors of poor outcome at hospital discharge following a spontaneous intracerebral hemorrhage. Int J Neurosci. 2011;121(5):267–70.
[34] Martí-Fàbregas J, Piles S, Guardia E, Martí-Vilalta J-L. Spontaneous primary intraventricular hemorrhage: clinical data, etiology, and outcome. J Neurol. 1999;246(4):287–91.
[35] Zeiler FA, Lo BWY, Akoth E, Silvaggio J, Kaufmann AM, Teitelbaum J, et al. Predicting outcome in subarachnoid hemorrhage (SAH) utilizing the Full Outline of Unresponsiveness (FOUR) score. Neurocrit Care. 2017;27(3):381–91.
[36] Thamarai, P., Adalarasu, K. An effective method to remove noise in EEG signal using wavelet packet transform (2018) International Journal of Pharmaceutical Research, 10 (4), pp. 793-799. https://www.scopus.com/inward/record.uri?eid=2-s2.0-85062401962&partnerID=40&md5=4364f50cfe8fa13d7c6f428ce119748b
[37] Shivshankar r. Mane (2019) advances of hydrazone linker in polymeric drug delivery. Journal of Critical Reviews, 6 (2), 1-4. doi:10.22159/jcr.2019v6i2.31833
[38] Vekaria A, Gigani Y, Belemkar S. "Cardiovascular Indications and Complications of Recombinant Human Erythropoietin." Systematic Reviews in Pharmacy 2.1 (2011), 43-47. Print. doi:10.4103/0975-8453.83438
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