The Barrow Neurological Institute Grading Scale as a Predictor for Delayed Cerebral Ischemia and Outcome After Aneurysmal Subarachnoid Hemorrhage: Data From a Nationwide Patient Registry (Swiss SOS).
Details
Serval ID
serval:BIB_8B1B21495492
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
The Barrow Neurological Institute Grading Scale as a Predictor for Delayed Cerebral Ischemia and Outcome After Aneurysmal Subarachnoid Hemorrhage: Data From a Nationwide Patient Registry (Swiss SOS).
Journal
Neurosurgery
Working group(s)
Swiss SOS study group
Contributor(s)
Fandino J., Marbacher S., D'Alonzo D., Coluccia D., Schmid N., Zumofen D., Roethlisberger M., Mariani L., Guzman R., Monsch A.U., Bläsi S., Fung C., Bervini D., Beck J., Raabe A., Goldberg J., Schöni D., Gralla J., Zweifel-Zehnder A., Gutbrod K., Müri R., Maduri R., Thomas Daniel R., Starnoni D., Messerer M., Levivier M., Beaud V., Valsecchi D., Arrighi M., Venier A., Reinert M., Kuhlen D.E., Robert T., Rossi S., Sacco L., Bijlenga P., Corniola M., Schaller K., Chicherio C., Seule M.A., Ferrari A., Weyerbrock A., Hlavica M., Fournier J.Y., Früh S., Schatlo B., Burkhardt J.K., Stienen M.N., Keller E., Regli L., Bozinov O., Maldaner N., Finkenstädt S., Neidert M.C., Brugger P., Mondadori C.
ISSN
1524-4040 (Electronic)
ISSN-L
0148-396X
Publication state
Published
Issued date
01/12/2018
Peer-reviewed
Oui
Volume
83
Number
6
Pages
1286-1293
Language
english
Notes
Publication types: Journal Article ; Multicenter Study
Publication Status: ppublish
Publication Status: ppublish
Abstract
The Barrow Neurological Institute (BNI) scale is a novel quantitative scale measuring maximal subarachnoid hemorrhage (SAH) thickness to predict delayed cerebral ischemia (DCI). This scale could replace the Fisher score, which was traditionally used for DCI prediction.
To validate the BNI scale.
All patient data were obtained from the prospective aneurysmal SAH multicenter registry. In 1321 patients, demographic data, BNI scale, DCI, and modified Rankin Scale (mRS) score up to the 1-yr follow-up (1FU) were available for descriptive and univariate statistics. Outcome was dichotomized in favorable (mRS 0-2) and unfavorable (mRS 3-6). Odds ratios (OR) for DCI of Fisher 3 patients (n = 1115, 84%) compared to a control cohort of Fisher grade 1, 2, and 4 patients (n = 206, 16%) were calculated for each BNI grade separately.
Overall, 409 patients (31%) developed DCI with a high DCI rate in the Fisher 3 cohort (34%). With regard to the BNI scale, DCI rates went up progressively from 26% (BNI 2) to 38% (BNI 5) and corresponding OR for DCI increased from 1.9 (1.0-3.5, 95% confidence interval) to 3.4 (2.1-5.3), respectively. BNI grade 5 patients had high rates of unfavorable outcome with 75% at discharge and 58% at 1FU. Likelihood for unfavorable outcome was high in BNI grade 5 patients with OR 5.9 (3.9-8.9) at discharge and OR 6.6 (4.1-10.5) at 1FU.
This multicenter external validation analysis confirms that patients with a higher BNI grade show a significantly higher risk for DCI; high BNI grade was a predictor for unfavorable outcome at discharge and 1FU.
To validate the BNI scale.
All patient data were obtained from the prospective aneurysmal SAH multicenter registry. In 1321 patients, demographic data, BNI scale, DCI, and modified Rankin Scale (mRS) score up to the 1-yr follow-up (1FU) were available for descriptive and univariate statistics. Outcome was dichotomized in favorable (mRS 0-2) and unfavorable (mRS 3-6). Odds ratios (OR) for DCI of Fisher 3 patients (n = 1115, 84%) compared to a control cohort of Fisher grade 1, 2, and 4 patients (n = 206, 16%) were calculated for each BNI grade separately.
Overall, 409 patients (31%) developed DCI with a high DCI rate in the Fisher 3 cohort (34%). With regard to the BNI scale, DCI rates went up progressively from 26% (BNI 2) to 38% (BNI 5) and corresponding OR for DCI increased from 1.9 (1.0-3.5, 95% confidence interval) to 3.4 (2.1-5.3), respectively. BNI grade 5 patients had high rates of unfavorable outcome with 75% at discharge and 58% at 1FU. Likelihood for unfavorable outcome was high in BNI grade 5 patients with OR 5.9 (3.9-8.9) at discharge and OR 6.6 (4.1-10.5) at 1FU.
This multicenter external validation analysis confirms that patients with a higher BNI grade show a significantly higher risk for DCI; high BNI grade was a predictor for unfavorable outcome at discharge and 1FU.
Keywords
Adult, Aged, Brain Ischemia/etiology, Cohort Studies, Female, Humans, Male, Middle Aged, Odds Ratio, Prospective Studies, Registries, Risk Factors, Subarachnoid Hemorrhage/complications
Pubmed
Web of science
Create date
27/01/2018 13:44
Last modification date
15/10/2020 11:32
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