Cerebellar Stroke Score and Grading Scale for the Prediction of Mortality and Outcomes in Ischemic Cerebellar Stroke.


Journal

Stroke
ISSN: 1524-4628
Titre abrégé: Stroke
Pays: United States
ID NLM: 0235266

Informations de publication

Date de publication:
Oct 2023
Historique:
medline: 23 10 2023
pubmed: 8 8 2023
entrez: 8 8 2023
Statut: ppublish

Résumé

Several individual predictors for outcomes in patients with cerebellar stroke (CS) have been previously identified. There is, however, no established clinical score for CS. Therefore, the aim of this study was to develop simple and accurate grading scales for patients with CS in an effort to better estimate mortality and outcomes. This multicentric retrospective study included 531 patients with ischemic CS presenting to 5 different academic neurosurgical and neurological departments throughout Germany between 2008 and 2021. Logistic regression analysis was performed to determine independent predictors related to 30-day mortality and unfavorable outcome (modified Rankin Scale score of 4-6). By weighing each parameter via calculation of regression coefficients, an ischemic CS-score and CS-grading scale (CS-GS) were developed and internally validated. Independent predictors for 30-day mortality were aged ≥70 years (odds ratio, 5.2), Glasgow Coma Scale score 3 to 4 at admission (odds ratio, 2.6), stroke volume ≥25 cm The CS-score and CS-GS are simple and accurate grading scales for the prediction of 30-day mortality and unfavorable outcome in patients with CS. While the score systems proposed here may not directly impact treatment decisions, it may help discuss mortality and outcome with patients and caregivers.

Sections du résumé

BACKGROUND BACKGROUND
Several individual predictors for outcomes in patients with cerebellar stroke (CS) have been previously identified. There is, however, no established clinical score for CS. Therefore, the aim of this study was to develop simple and accurate grading scales for patients with CS in an effort to better estimate mortality and outcomes.
METHODS METHODS
This multicentric retrospective study included 531 patients with ischemic CS presenting to 5 different academic neurosurgical and neurological departments throughout Germany between 2008 and 2021. Logistic regression analysis was performed to determine independent predictors related to 30-day mortality and unfavorable outcome (modified Rankin Scale score of 4-6). By weighing each parameter via calculation of regression coefficients, an ischemic CS-score and CS-grading scale (CS-GS) were developed and internally validated.
RESULTS RESULTS
Independent predictors for 30-day mortality were aged ≥70 years (odds ratio, 5.2), Glasgow Coma Scale score 3 to 4 at admission (odds ratio, 2.6), stroke volume ≥25 cm
CONCLUSIONS CONCLUSIONS
The CS-score and CS-GS are simple and accurate grading scales for the prediction of 30-day mortality and unfavorable outcome in patients with CS. While the score systems proposed here may not directly impact treatment decisions, it may help discuss mortality and outcome with patients and caregivers.

Identifiants

pubmed: 37551591
doi: 10.1161/STROKEAHA.123.043478
doi:

Types de publication

Multicenter Study Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

2569-2575

Auteurs

Sae-Yeon Won (SY)

Department of Neurosurgery (S.-Y.W., B.B., D.D., T.M.F., K.H., S.T., F.G.), University Medical Center Rostock, Germany.

Ruzanna Melkonian (R)

Department of Neurosurgery (R.M., C.S., N.D.), Jena University Hospital, Germany.

Bedjan Behmanesh (B)

Department of Neurosurgery (S.-Y.W., B.B., D.D., T.M.F., K.H., S.T., F.G.), University Medical Center Rostock, Germany.

Joshua D Bernstock (JD)

Department of Neurosurgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA (J.D.B.).

Marcus Czabanka (M)

Department of Neurosurgery, University Hospital, Goethe University Hospital, Frankfurt, Germany (M.C., J.K.).

Daniel Dubinski (D)

Department of Neurosurgery (S.-Y.W., B.B., D.D., T.M.F., K.H., S.T., F.G.), University Medical Center Rostock, Germany.

Thomas M Freiman (TM)

Department of Neurosurgery (S.-Y.W., B.B., D.D., T.M.F., K.H., S.T., F.G.), University Medical Center Rostock, Germany.

Albrecht Günther (A)

Department of Neurology (A.G.), Jena University Hospital, Germany.

Kara Hellmuth (K)

Department of Neurosurgery (S.-Y.W., B.B., D.D., T.M.F., K.H., S.T., F.G.), University Medical Center Rostock, Germany.

Silvia Hernandez-Duran (S)

Department of Neurosurgery, Göttingen University Hospital, Germany (S.H.-D., D.M., V.R.).

Eva Herrmann (E)

Department of Medicine, Institute of Biostatistics and Mathematical Modelling, Goethe University Hospital, Frankfurt am Main, Germany (E.H.).

Juergen Konczalla (J)

Department of Neurosurgery, University Hospital, Goethe University Hospital, Frankfurt, Germany (M.C., J.K.).

Ilko Maier (I)

Department of Neurology, Göttingen University Hospital, Germany (I.M.).

Dorothee Mielke (D)

Department of Neurosurgery, Göttingen University Hospital, Germany (S.H.-D., D.M., V.R.).

Paul Naser (P)

Department of Neurosurgery, University of Heidelberg, Germany (P.N., A.U., J.W.).

Veit Rohde (V)

Department of Neurosurgery, Göttingen University Hospital, Germany (S.H.-D., D.M., V.R.).

Jan Hendrik Schaefer (JH)

Department of Neurology, Goethe University Hospital Frankfurt, Germany (J.H.S.).

Christian Senft (C)

Department of Neurosurgery (R.M., C.S., N.D.), Jena University Hospital, Germany.

Alexander Storch (A)

Department of Neurology (A.S., U.W., M.W.), University Medical Center Rostock, Germany.

Svorad Trnovec (S)

Department of Neurosurgery (S.-Y.W., B.B., D.D., T.M.F., K.H., S.T., F.G.), University Medical Center Rostock, Germany.

Andreas Unterberg (A)

Department of Neurosurgery, University of Heidelberg, Germany (P.N., A.U., J.W.).

Johannes Walter (J)

Department of Neurosurgery, University of Heidelberg, Germany (P.N., A.U., J.W.).

Uwe Walter (U)

Department of Neurology (A.S., U.W., M.W.), University Medical Center Rostock, Germany.

Matthias Wittstock (M)

Department of Neurology (A.S., U.W., M.W.), University Medical Center Rostock, Germany.

Nazife Dinc (N)

Department of Neurosurgery (R.M., C.S., N.D.), Jena University Hospital, Germany.

Florian Gessler (F)

Department of Neurosurgery (S.-Y.W., B.B., D.D., T.M.F., K.H., S.T., F.G.), University Medical Center Rostock, Germany.

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