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Article: Risk score to predict hospital-acquired pneumonia after spontaneous intracerebral hemorrhage

TitleRisk score to predict hospital-acquired pneumonia after spontaneous intracerebral hemorrhage
Authors
Keywordsforecasting
cerebral hemorrhage
pneumonia
Issue Date2014
Citation
Stroke, 2014, v. 45, n. 9, p. 2620-2628 How to Cite?
AbstractBACKGROUND AND PURPOSE-: We aimed to develop a risk score (intracerebral hemorrhage-associated pneumonia score, ICH-APS) for predicting hospital-acquired stroke-associated pneumonia (SAP) after ICH. METHODS-: The ICH-APS was developed based on the China National Stroke Registry (CNSR), in which eligible patients were randomly divided into derivation (60%) and validation (40%) cohorts. Variables routinely collected at presentation were used for predicting SAP after ICH. For testing the added value of hematoma volume measure, we separately developed 2 models with (ICH-APS-B) and without (ICH-APS-A) hematoma volume included. Multivariable logistic regression was performed to identify independent predictors. The area under the receiver operating characteristic curve (AUROC), Hosmer-Lemeshow goodness-of-fit test, and integrated discrimination index were used to assess model discrimination, calibration, and reclassification, respectively. RESULTS-: The SAP was 16.4% and 17.7% in the overall derivation (n=2998) and validation (n=2000) cohorts, respectively. A 23-point ICH-APS-A was developed based on a set of predictors and showed good discrimination in the overall derivation (AUROC, 0.75; 95% confidence interval, 0.72-0.77) and validation (AUROC, 0.76; 95% confidence interval, 0.71-0.79) cohorts. The ICH-APS-A was more sensitive for patients with length of stay >48 hours (AUROC, 0.78; 95% confidence interval, 0.75-0.81) than those with length of stay <48 hours (AUROC, 0.64; 95% confidence interval, 0.55-0.73). The ICH-APS-A was well calibrated (Hosmer-Lemeshow test) in the derivation (P=0.20) and validation (P=0.66) cohorts. Similarly, a 26-point ICH-APS-B was established. The ICH-APS-A and ICH-APS-B were not significantly different in discrimination and reclassification for SAP after ICH. CONCLUSION-: The ICH-APSs are valid risk scores for predicting SAP after ICH, especially for patients with length of stay >48 hours. © 2014 American Heart Association, Inc.
Persistent Identifierhttp://hdl.handle.net/10722/219759
ISSN
2015 Impact Factor: 5.787
2015 SCImago Journal Rankings: 3.671

 

DC FieldValueLanguage
dc.contributor.authorJi, Ruijun-
dc.contributor.authorShen, Haipeng-
dc.contributor.authorPan, Yuesong-
dc.contributor.authorDu, Wanliang-
dc.contributor.authorWang, Penglian-
dc.contributor.authorLiu, Gaifen-
dc.contributor.authorWang, Yilong-
dc.contributor.authorLi, Hao-
dc.contributor.authorZhao, Xingquan-
dc.contributor.authorWang, Yongjun-
dc.date.accessioned2015-09-23T02:57:54Z-
dc.date.available2015-09-23T02:57:54Z-
dc.date.issued2014-
dc.identifier.citationStroke, 2014, v. 45, n. 9, p. 2620-2628-
dc.identifier.issn0039-2499-
dc.identifier.urihttp://hdl.handle.net/10722/219759-
dc.description.abstractBACKGROUND AND PURPOSE-: We aimed to develop a risk score (intracerebral hemorrhage-associated pneumonia score, ICH-APS) for predicting hospital-acquired stroke-associated pneumonia (SAP) after ICH. METHODS-: The ICH-APS was developed based on the China National Stroke Registry (CNSR), in which eligible patients were randomly divided into derivation (60%) and validation (40%) cohorts. Variables routinely collected at presentation were used for predicting SAP after ICH. For testing the added value of hematoma volume measure, we separately developed 2 models with (ICH-APS-B) and without (ICH-APS-A) hematoma volume included. Multivariable logistic regression was performed to identify independent predictors. The area under the receiver operating characteristic curve (AUROC), Hosmer-Lemeshow goodness-of-fit test, and integrated discrimination index were used to assess model discrimination, calibration, and reclassification, respectively. RESULTS-: The SAP was 16.4% and 17.7% in the overall derivation (n=2998) and validation (n=2000) cohorts, respectively. A 23-point ICH-APS-A was developed based on a set of predictors and showed good discrimination in the overall derivation (AUROC, 0.75; 95% confidence interval, 0.72-0.77) and validation (AUROC, 0.76; 95% confidence interval, 0.71-0.79) cohorts. The ICH-APS-A was more sensitive for patients with length of stay >48 hours (AUROC, 0.78; 95% confidence interval, 0.75-0.81) than those with length of stay <48 hours (AUROC, 0.64; 95% confidence interval, 0.55-0.73). The ICH-APS-A was well calibrated (Hosmer-Lemeshow test) in the derivation (P=0.20) and validation (P=0.66) cohorts. Similarly, a 26-point ICH-APS-B was established. The ICH-APS-A and ICH-APS-B were not significantly different in discrimination and reclassification for SAP after ICH. CONCLUSION-: The ICH-APSs are valid risk scores for predicting SAP after ICH, especially for patients with length of stay >48 hours. © 2014 American Heart Association, Inc.-
dc.languageeng-
dc.relation.ispartofStroke-
dc.subjectforecasting-
dc.subjectcerebral hemorrhage-
dc.subjectpneumonia-
dc.titleRisk score to predict hospital-acquired pneumonia after spontaneous intracerebral hemorrhage-
dc.typeArticle-
dc.description.natureLink_to_subscribed_fulltext-
dc.identifier.doi10.1161/STROKEAHA.114.005023-
dc.identifier.pmid25028448-
dc.identifier.scopuseid_2-s2.0-84906807987-
dc.identifier.volume45-
dc.identifier.issue9-
dc.identifier.spage2620-
dc.identifier.epage2628-
dc.identifier.eissn1524-4628-

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