The Spot Sign Score in Primary Intracerebral Hemorrhage Identifies Patients at Highest Risk of In-Hospital Mortality and Poor Outcome Among Survivors
- 1 January 2010
- journal article
- research article
- Published by Ovid Technologies (Wolters Kluwer Health) in Stroke
- Vol. 41 (1), 54-60
- https://doi.org/10.1161/strokeaha.109.565382
Abstract
Background and Purpose— The spot sign score is a potent predictor of hematoma expansion in patients with primary intracerebral hemorrhage (ICH). We aim to determine the accuracy of this scoring system for the prediction of in-hospital mortality and poor outcome among survivors in patients with primary ICH. Methods— Three neuroradiologists retrospectively reviewed CT angiograms (CTAs) performed in 573 consecutive patients who presented to our Emergency Department with primary ICH over a 9-year period to determine the presence and scoring of spot signs according to strict criteria. Baseline ICH and intraventricular hemorrhage volumes were independently determined by computer-assisted volumetric analysis. Medical records were independently reviewed for baseline clinical characteristics and modified Rankin Scale (mRS) at hospital discharge and 3-month follow-up. Poor outcome among survivors was defined as a mRS ≥4 at 3-month follow-up. Results— We identified spot signs in 133 of 573 CTAs (23.2%), 11 of which were delayed spot signs (8.3%). The presence of any spot sign increased the risk of in-hospital mortality (55.6%, OR 4.0, 95% CI 2.6 to 5.9, P P P P Conclusion— The spot sign score is an independent predictor of in-hospital mortality and poor outcome among survivors in primary ICH.This publication has 18 references indexed in Scilit:
- Intensive blood pressure reduction in acute cerebral haemorrhage trial (INTERACT): a randomised pilot trialThe Lancet Neurology, 2008
- Vascular and Nonvascular Mimics of the CT Angiography “Spot Sign” in Patients With Secondary Intracerebral HemorrhageStroke, 2008
- Contrast Extravasation on CT Predicts Mortality in Primary Intracerebral HemorrhageAmerican Journal of Neuroradiology, 2007
- CT Angiography “Spot Sign” Predicts Hematoma Expansion in Acute Intracerebral HemorrhageStroke, 2007
- Contrast extravasation on CT angiography predicts hematoma expansion in intracerebral hemorrhageNeurology, 2007
- Hematoma growth is a determinant of mortality and poor outcome after intracerebral hemorrhageNeurology, 2006
- Recombinant Activated Factor VII for Acute Intracerebral HemorrhageThe New England Journal of Medicine, 2005
- Safety and Feasibility of Recombinant Factor VIIa for Acute Intracerebral HemorrhageStroke, 2005
- Spontaneous Intracerebral HemorrhageThe New England Journal of Medicine, 2001
- Extravasation of radiographic contrast is an independent predictor of death in primary intracerebral hemorrhage.Stroke, 1999