Novel score predicting gastrostomy tube placement in intracerebral hemorrhage

Research output: Contribution to journalArticle

Abstract

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.

Original languageEnglish (US)
Pages (from-to)31-36
Number of pages6
JournalStroke
Volume46
Issue number1
DOIs
StatePublished - Jan 3 2015

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Gastrostomy
Cerebral Hemorrhage
Odds Ratio
Glasgow Coma Scale
Confidence Intervals
Deglutition Disorders
Area Under Curve
Logistic Models
Morbidity
Sensitivity and Specificity

Keywords

  • cerebral hemorrhage
  • enteral nutrition
  • stroke
  • tube feeding

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Clinical Neurology
  • Advanced and Specialized Nursing

Cite this

@article{733085c8de854b77be088cc02d9c2cbc,
title = "Novel score predicting gastrostomy tube placement in intracerebral hemorrhage",
abstract = "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.",
keywords = "cerebral hemorrhage, enteral nutrition, stroke, tube feeding",
author = "Romanus Faigle and Marsh, {Elisabeth Breese} and Llinas, {Rafael H} and Victor Urrutia and Gottesman, {Rebecca F}",
year = "2015",
month = "1",
day = "3",
doi = "10.1161/STROKEAHA.114.006891",
language = "English (US)",
volume = "46",
pages = "31--36",
journal = "Stroke",
issn = "0039-2499",
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T1 - Novel score predicting gastrostomy tube placement in intracerebral hemorrhage

AU - Faigle, Romanus

AU - Marsh, Elisabeth Breese

AU - Llinas, Rafael H

AU - Urrutia, Victor

AU - Gottesman, Rebecca F

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

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