The modified graeb score: an enhanced tool for intraventricular hemorrhage measurement and prediction of functional outcome

Morgan, T.C. et al. (2013) The modified graeb score: an enhanced tool for intraventricular hemorrhage measurement and prediction of functional outcome. Stroke, 44(3), pp. 635-641. (doi: 10.1161/STROKEAHA.112.670653)

Abstract

<p>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.</p> <p>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).</p> <p>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.</p> <p>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.</p>

• Item Type: Articles
• Status: Published
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: Walters, Professor Matthew and Lees, Professor Kennedy and Dawson, Professor Jesse and Quinn, Professor Terry and Higgins, Dr Peter
• Authors: Morgan, T.C., Dawson, J., Spengler, D., Lees, K.R., Aldrich, C., Mishra, N.K., Lane, K., Quinn, T.J., Diener-West, M., Weir, C.J., Higgins, P., Rafferty, M., Kinsley, K., Ziai, W., Awad, I., Walters, M.R., and Hanley, D.
• College/School: College of Medical Veterinary and Life Sciences > School of Cardiovascular & Metabolic Health; College of Medical Veterinary and Life Sciences > School of Medicine, Dentistry & Nursing
• Journal Name: Stroke
• Publisher: American Heart Association
• ISSN: 0039-2499
• ISSN (Online): 1524-4628
• Published Online: 31 January 2013