TY - JOUR
T1 - Early identification of intracranial hemorrhage using a predictive nomogram
AU - Chandler, Frances Leah
AU - Kane, Joyce
AU - Blackford, Amanda L.
AU - Weinberger, Margaux
AU - Wagner, Kavitha C.
AU - Gojo, Ivana
AU - Cohen, Melanie
AU - Apostol, Colleen
N1 - Publisher Copyright:
Copyright 2018 by the Oncology Nursing Society.
PY - 2018/3
Y1 - 2018/3
N2 - OBJECTIVES: To identify predictive signs and symptoms occurring in hospitalized adults with hematologic malignancies with intracranial hemorrhage (IH). SAMPLE & SETTING: In a National Cancer Institute (NCI)-designated comprehensive cancer center, a retrospective matched case-control design included adult inpatients with hematologic malignancies with (n = 39) and without (n = 39) IH. METHODS & VARIABLES: Conditional logistic regression, t test, and Fisher's exact tests were used to assess increased risks for IH and the development of a prognostic nomogram with signs, symptoms, and laboratory values relevant to IH. RESULTS: Composite outcomes for signs, symptoms, and laboratory values were included in a prognostic nomogram that had good discriminative ability to predict IH, with a bootstrap corrected concordance index of 0.766 (95% confidence interval [0.657, 0.866]) and good calibration. Prognostic nomogram predicted patients with prolonged activated partial thromboplastin time (APTT) (greater than 30.6), headache, and systolic blood pressure (SBP) of 140 or greater were more likely to have IH. IMPLICATIONS FOR NURSING: Nurses should recognize that patients with the combination of prolonged APTT, SBP of 140 or greater, and headache are more likely to have IH.
AB - OBJECTIVES: To identify predictive signs and symptoms occurring in hospitalized adults with hematologic malignancies with intracranial hemorrhage (IH). SAMPLE & SETTING: In a National Cancer Institute (NCI)-designated comprehensive cancer center, a retrospective matched case-control design included adult inpatients with hematologic malignancies with (n = 39) and without (n = 39) IH. METHODS & VARIABLES: Conditional logistic regression, t test, and Fisher's exact tests were used to assess increased risks for IH and the development of a prognostic nomogram with signs, symptoms, and laboratory values relevant to IH. RESULTS: Composite outcomes for signs, symptoms, and laboratory values were included in a prognostic nomogram that had good discriminative ability to predict IH, with a bootstrap corrected concordance index of 0.766 (95% confidence interval [0.657, 0.866]) and good calibration. Prognostic nomogram predicted patients with prolonged activated partial thromboplastin time (APTT) (greater than 30.6), headache, and systolic blood pressure (SBP) of 140 or greater were more likely to have IH. IMPLICATIONS FOR NURSING: Nurses should recognize that patients with the combination of prolonged APTT, SBP of 140 or greater, and headache are more likely to have IH.
KW - Head bleed
KW - Hematologic malignancies
KW - Intracranial hemorrhage
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U2 - 10.1188/18.ONF.177-186
DO - 10.1188/18.ONF.177-186
M3 - Article
C2 - 29466342
AN - SCOPUS:85042431463
SN - 0190-535X
VL - 45
SP - 177
EP - 186
JO - Oncology nursing forum
JF - Oncology nursing forum
IS - 2
ER -