External validation of brain arteriovenous malformation haemorrhage scores, AVICH, ICH and R2eD

Taweel, Basel A ORCID: 0000-0002-6157-2438, Gillespie, Conor S, Richardson, George E, Mustafa, Mohammad A, Ali, Tamara, Islim, Abdurrahman I, Hannan, Cathal J and Chavredakis, Emmanuel (2022) External validation of brain arteriovenous malformation haemorrhage scores, AVICH, ICH and R2eD. ACTA NEUROCHIRURGICA, 164 (6). pp. 1685-1692.

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Official URL: http://dx.doi.org/10.1007/s00701-022-05190-1

Abstract

<h4>Purpose</h4>To externally validate the arteriovenous malformation-related intracerebral haemorrhage (AVICH), intracerebral haemorrhage (ICH), and novel haemorrhage presentation risk score (R2eD) in brain arteriovenous malformations.<h4>Methods</h4>Adult patients diagnosed radiologically with an arteriovenous malformation (AVM) at a tertiary neurosurgical centre between 2007 and 2018 were eligible for inclusion. Both the AVICH and ICH scores were calculated for AVM-related symptomatic haemorrhage (SH) and compared against the modified Rankin scale (mRS) at discharge and last follow-up, with unfavourable outcome defined as mRS > 2. R2eD scores were stratified based on presentation with SH. External validity was assessed using Harrel's C-statistic.<h4>Results</h4>Two hundred fifty patients were included. Mean age at diagnosis was 46.2 years [SD = 16.5]). Eighty-seven patients (34.8%) had a SH, with 83 included in the analysis. Unfavourable mRS outcome was seen in 18 (21.6%) patients at discharge and 18 (21.6%) patients at last follow-up. The AVICH score C-statistic was 0.67 (95% confidence interval [CI], 0.53-0.80) at discharge and 0.70 (95% CI, 0.56-0.84) at last follow-up. The ICH score C-statistic was 0.78 (95% CI 0.67-0.88), at discharge and 0.80 (95% CI 0.69-0.91) at last follow-up. The R2eD score C-statistic for predicting AVM haemorrhage was 0.60 (95% CI, 0.53-0.67).<h4>Conclusions</h4>The AVICH score showed fair-poor performance, while the ICH score showed good-fair performance. The R2eD score demonstrated poor performance, and its clinical utility in predicting AVM haemorrhage remains unclear.

Item Type:	Article
Uncontrolled Keywords:	Arteriovenous malformations, Cerebral haemorrhage, Prognosis, Cerebrovascular disorders
Divisions:	Faculty of Health and Life Sciences
Depositing User:	Symplectic Admin
Date Deposited:	22 Jun 2022 09:50
Last Modified:	18 Jan 2023 20:57
DOI:	10.1007/s00701-022-05190-1
Open Access URL:	https://doi.org/10.1007/s00701-022-05190-1
Related URLs:	Author Publisher
URI:	https://livrepository.liverpool.ac.uk/id/eprint/3156974