TY - JOUR
T1 - The modified graeb score
T2 - An enhanced tool for intraventricular hemorrhage measurement and prediction of functional outcome
AU - Morgan, Timothy C.
AU - Dawson, Jesse
AU - Spengler, Danielle
AU - Lees, Kennedy R.
AU - Aldrich, Chanel
AU - Mishra, Nishant K.
AU - Lane, Karen
AU - Quinn, Terence J.
AU - Diener-West, Marie
AU - Weir, Christopher J.
AU - Higgins, Peter
AU - Rafferty, Mark
AU - Kinsley, Katie
AU - Ziai, Wendy
AU - Awad, Issam
AU - Walters, Matthew R.
AU - Hanley, Daniel
PY - 2013/3
Y1 - 2013/3
N2 - Background and Purpose-Simple and rapid measures of intraventricular hemorrhage (IVH) volume are lacking. We developed and validated a modification of the original Graeb scale to facilitate rapid assessment of IVH over time. Methods-We explored the relationship between the modified Graeb scale (mGS), original Graeb scale, measured IVH volume, and outcome using data from the Clot Lysis: Evaluating Accelerated Resolution of Hemorrhage with rtPA B (CLEAR B) study. We also explored its reliability. We then evaluated the relationship between mGS and outcome in a large sample of participants with IVH using data contained within the Virtual International Stroke Trials Archive (VISTA). We defined outcome using the modified Rankin scale (>3 signifying poor outcome). Results-The CLEAR B study included 360 scans from 36 subjects. The mGS score and IVH volume were highly correlated (R = 0.80, P<0.0001, R2 0.65). Baseline mGS was predictive of poor outcome (area under receiving operating characteristic curve 0.74, 95% confidence interval, 0.57-0.91), whereas the original Graeb scale was not. The VISTA study included 399 participants. Each unit increase in the mGS led to a 12% increase in the odds of a poor outcome (odds ratio, 1.12; 95% confidence interval, 1.05-1.19). Measures of reliability (intra- and inter- reader) were good in both studies. Conclusions-The mGS, a semiquantitative scale for IVH volume measurement, is a reliable measure with prognostic validity suitable for rapid use in clinical practice and in research.
AB - Background and Purpose-Simple and rapid measures of intraventricular hemorrhage (IVH) volume are lacking. We developed and validated a modification of the original Graeb scale to facilitate rapid assessment of IVH over time. Methods-We explored the relationship between the modified Graeb scale (mGS), original Graeb scale, measured IVH volume, and outcome using data from the Clot Lysis: Evaluating Accelerated Resolution of Hemorrhage with rtPA B (CLEAR B) study. We also explored its reliability. We then evaluated the relationship between mGS and outcome in a large sample of participants with IVH using data contained within the Virtual International Stroke Trials Archive (VISTA). We defined outcome using the modified Rankin scale (>3 signifying poor outcome). Results-The CLEAR B study included 360 scans from 36 subjects. The mGS score and IVH volume were highly correlated (R = 0.80, P<0.0001, R2 0.65). Baseline mGS was predictive of poor outcome (area under receiving operating characteristic curve 0.74, 95% confidence interval, 0.57-0.91), whereas the original Graeb scale was not. The VISTA study included 399 participants. Each unit increase in the mGS led to a 12% increase in the odds of a poor outcome (odds ratio, 1.12; 95% confidence interval, 1.05-1.19). Measures of reliability (intra- and inter- reader) were good in both studies. Conclusions-The mGS, a semiquantitative scale for IVH volume measurement, is a reliable measure with prognostic validity suitable for rapid use in clinical practice and in research.
KW - Cerebral hemorrhage
KW - Interobserver variation
KW - Intraventricular pressure
KW - Outcomes assessment
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U2 - 10.1161/STROKEAHA.112.670653
DO - 10.1161/STROKEAHA.112.670653
M3 - Article
C2 - 23370203
AN - SCOPUS:84876282629
SN - 0039-2499
VL - 44
SP - 635
EP - 641
JO - Stroke
JF - Stroke
IS - 3
ER -