Evaluating Hematoma Expansion Scores in Acute Spontaneous Intracerebral Hemorrhage: A Systematic Scoping Review. Issue 4 (April 2020)

• Record Type: Journal Article
• Authors: Yogendrakumar, Vignan; Moores, Margaret; Sikora, Lindsey; Shamy, Michel; Ramsay, Tim; Fergusson, Dean; Dowlatshahi, Dar
• Is Part Of: Stroke. Volume 51:Issue 4(2020)
• Publication Date: 2020-04
• Subjects: adult -- cerebral hemorrhage -- environment -- hematoma -- prognosis; Cerebrovascular disease -- Periodicals; Cerebral circulation -- Periodicals; 616.81
• DOI: 10.1161/STROKEAHA.119.028574
• Languages: English
• ISSNs: 0039-2499

Abstract

Abstract : Background and Purpose—: In acute spontaneous intracerebral hemorrhage, multiple hematoma expansion scores have been proposed for use in clinical trial environments. We performed a systematic scoping review to identify all existing hematoma expansion scores and describe their development, validation, and relative performance. Methods—: Two reviewers searched MEDLINE, PUBMED, EMBASE, and CENTRAL (Cochrane Central Register of Controlled Trials) for studies that derived or validated a hematoma expansion prediction score in adults presenting with spontaneous intracerebral hemorrhage. A descriptive analysis of the extracted data was performed, focusing on score development techniques and predictive capabilities. Results—: Of the 14 434 records retrieved, 15 studies met inclusion criteria and 10 prediction scores were identified. Validation analysis using independent samples was performed in 9 studies on 5 scores. All derivation studies reported high performance with C statistics ranging from 0.72 to 0.93. In validation, the C-statistic range was broader with studies reporting 0.62 to 0.77. For every score, the risk of expansion increased with each point increase, although patients with high scores were rare. Conclusions—: At present, 10 hematoma expansion scores have been developed, of which 5 have been externally validated. Real-world performance in validation studies was lower than performance in derivation studies. Data from the current literature are insufficient to support a meaningful meta-analysis. Abstract : Supplemental Digital Content is available in the text.