London, United Kingdom 2013 Cerebrovasc Dis 2013; 35 (suppl 3)1-854 133 10 Intracerebral/subarachnoid haemorrhage and venous diseases 12:00 - 12:10 The R-STEP SCORE: A Rapid Scoring System For Intracerebral Hemorrhage Patients: Our Step Towards A Simple and Systematic Decision Making Tool For Medical or Surgi-cal Management M.A.J Sta. Maria1, L.C. Racelis2, K.M. Esmeralda3, J.L. Pascual4 The Medical City, Pasig City, PHILIPPINES1,The Medical City, Pasig City, PHILIPPINES2, The Medical City, Pasig City, PHILIPPINES3, The Medical City, Pasig City, PHILIPPINES4 BACKGROUND AND OBJECTIVES: Several grading scales for intracerebral haemorrhage using clinical and imaging parameters that predict outcome have been published but to our knowledge, there is no study comparing functional outcomes in patients who were managed either conservative or surgically. We conceptualized a scale using known predictors and identi-fied a subgroup of patients who had benefited after surgery denoting good functional outcome. METHODS Charts of 429 consecutive patients with spontaneous intracerebral haemorrhage at our hospital from 2008-2011 were reviewed. Clinical, imaging parameters and outcomes using the Glasgow Outcome Scale (GOS) score were tabulated. Strongest predictors were determined using multivariate logistic regression analysis and a predictor scale was devised with cut-off values determined using receiver operating characteristics and Youden Index. Internal valida-tion was done through bootstrap techniques. RESULTS Age (p=0.07), volume (p=<0.0001), location of hematoma, (p=0.18), intraventricular extension (p=<0.01) and GCS score (p=<0.01) were determined as the strongest outcome predictors and were assigned specific ranges on our score. Functional outcomes were significantly better for surgery than conservative treatment at a scores of 5-8 (Youden Index=0.60, sensitivity 76.6%, specificity 83.1%, AUC=0.861). Internal validation through bootstrapping showed close results to the original analysis. (AUC=0.864) CONCLUSION Our analysis identified a subgroup of patients who benefited from surgery, hence depicting functional benefit which is important in decision making. Our scoring system can be used in the emergency setting to predict those patients who will benefit from surgical intervention because of its practicality, rapidity and ease of use. It is a simple yet comprehensive tool which can be easily used by physicians to minimize ambiguity in decision making for patients with spontaneous intracerebral haemorrhage.
Karger_ESC London_2013
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