TY - JOUR
T1 - Novel score predicting gastrostomy tube placement in intracerebral hemorrhage
AU - Faigle, Roland
AU - Marsh, Elisabeth B.
AU - Llinas, Rafael H.
AU - Urrutia, Victor C.
AU - Gottesman, Rebecca F.
N1 - Publisher Copyright:
© 2014 American Heart Association, Inc.
PY - 2015/1/3
Y1 - 2015/1/3
N2 - Results-Age (odds ratio [OR], 1.64 per 10-year increase in age; 95% confidence interval [CI], 1.02-2.65), black race (OR, 3.26; 95% CI, 0.96-11.05), Glasgow Coma Scale (OR, 0.80; 95% CI, 0.62-1.03), and ICH volume (OR, 1.38 per 10-mL increase in ICH volume) were independent predictors of PEG placement. The final model for score development achieved an area under the curve of 0.7911 (95% CI, 0.6931-0.8892) in the validation group. The score was named the GRAVo score: Glasgow Coma Scale ≤12 (2 points), Race (1 point for black), Age >50 years (2 points), and ICH Volume >30 mL (1 point). A score >4 was associated with a 12× higher odds of PEG placement when compared with a score ≤4 (OR, 11.81; 95% CI, 5.04-27.66), predicting PEG placement with 46.55% sensitivity and 93.13% specificity.Conclusions-The GRAVo score, combining information about Glasgow Coma Scale, race, age, and ICH volume, may be a useful predictor of PEG placement in ICH patients.Background and Purpose-Dysphagia after intracerebral hemorrhage (ICH) contributes significantly to morbidity, often necessitating placement of a percutaneous endoscopic gastrostomy (PEG) tube. This study describes a novel risk prediction score for PEG placement after ICH.Methods-We retrospectively analyzed data from 234 patients with ICH presenting during a 4-year period. One hundred eighty-nine patients met inclusion criteria. The sample was randomly divided into a development and a validation cohort. Logistic regression was used to develop a risk score by weighting predictors of PEG placement based on strength of association.
AB - Results-Age (odds ratio [OR], 1.64 per 10-year increase in age; 95% confidence interval [CI], 1.02-2.65), black race (OR, 3.26; 95% CI, 0.96-11.05), Glasgow Coma Scale (OR, 0.80; 95% CI, 0.62-1.03), and ICH volume (OR, 1.38 per 10-mL increase in ICH volume) were independent predictors of PEG placement. The final model for score development achieved an area under the curve of 0.7911 (95% CI, 0.6931-0.8892) in the validation group. The score was named the GRAVo score: Glasgow Coma Scale ≤12 (2 points), Race (1 point for black), Age >50 years (2 points), and ICH Volume >30 mL (1 point). A score >4 was associated with a 12× higher odds of PEG placement when compared with a score ≤4 (OR, 11.81; 95% CI, 5.04-27.66), predicting PEG placement with 46.55% sensitivity and 93.13% specificity.Conclusions-The GRAVo score, combining information about Glasgow Coma Scale, race, age, and ICH volume, may be a useful predictor of PEG placement in ICH patients.Background and Purpose-Dysphagia after intracerebral hemorrhage (ICH) contributes significantly to morbidity, often necessitating placement of a percutaneous endoscopic gastrostomy (PEG) tube. This study describes a novel risk prediction score for PEG placement after ICH.Methods-We retrospectively analyzed data from 234 patients with ICH presenting during a 4-year period. One hundred eighty-nine patients met inclusion criteria. The sample was randomly divided into a development and a validation cohort. Logistic regression was used to develop a risk score by weighting predictors of PEG placement based on strength of association.
KW - cerebral hemorrhage
KW - enteral nutrition
KW - stroke
KW - tube feeding
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U2 - 10.1161/STROKEAHA.114.006891
DO - 10.1161/STROKEAHA.114.006891
M3 - Article
C2 - 25468881
AN - SCOPUS:84920491955
SN - 0039-2499
VL - 46
SP - 31
EP - 36
JO - Stroke
JF - Stroke
IS - 1
ER -