Validation of the Intracerebral Hemorrhage Score in Uganda

Almasi‐Hashiani, Amir; Chang, Jonathan L.; O’Carroll, Cumara B; Okello, Samson; Olum, Sam; Acan, Moses; Aden, Abdirahim Abdi; Chow, Felicia C.; Siedner, Mark J.

doi:10.1161/strokeaha.118.022057

Cited by 6 publications

(6 citation statements)

References 14 publications

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“…Initial CT scan of brain has an important role in predicting outcome of patients with ICH. Volume of hematoma was unequivocally seen to be associated with mortality 9,14,17,18,21 ; which is also true for our study. (CAVA) 22 , it is still useful as an rapid and reliable method 23 .…”

Section: Discussionsupporting

confidence: 86%

Predictors of Outcome in Intracerebral Hemorrhage and Performance of Hemphill ICH Score and GVS Score

Islam

Hasan

Mukherjee

et al. 2021

J. Natl Inst. Neurosci Bangladesh

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Background: The outcome of intracerebral hemorrhage (ICH) is gloomy. There are several scoring systems for predicting its outcome. Objective: The purpose of the present study was to observe the predictors of outcome in ICH patients and to assess the performance of ‘Hemphill ICH score’ and ‘GVS score’. Methodology: This cohort study involved patients of ICH admitted within 72 hours of acute event in July to December 2017 in the Department of Neurology at National Institute of Neurosciences (NINS) & Hospital, Dhaka, Bangladesh. Clinical and radiological data at admission and in-hospital events were obtained from medical records. Patients who were discharged from the hospital were interviewed at 30th day after event by face to face interview or over telephone. Follow up data was not found for 4 patients. Results: This study involved 115 patients of ICH [median age 60 years (interquartile range, IQR 50-70); 46% (53/115) female]. In-hospital and 30-day mortality of the ICH patients was 22% (25/115: 95% CI 15-30%) and 38% (42/111; 95% CI 29–48%) respectively. There was almost perfect agreement between Hemphill ICH score and GVS score (p<0.001 and κ=0.862). Kaplan-Meier survival curves of patients with different Hemphill ICH scores revealed significant difference among them; which was also true for patients with different GVS scores (by log-rank test, p<0.001 for both). The area under the curve (AUC) for the Hemphill ICH score to predict mortality was 0.70 (95% CI, 0.60–0.80) and for the GVS score 0.74 (95% CI, 0.64–0.83). In bivariate logistic regression, NIHSS score, GCS score, blood glucose at admission, nosocomial pneumonia, ICH volume, midline shift along with both Hemphill ICH and GVS score were observed to predict mortality at 30 days (p<0.05 for all). In two separate models adjusting for blood glucose and nosocomial pneumonia, every 1-point increase in the Hemphill ICH score and GVS score increases the mortality risk by 2.35 fold (adjusted OR: 2.35; 95% CI 1.33-4.16; p=0.003) and 2.99 fold (adjusted OR: 2.99; 95% CI 1.57-5.72; p=0.001) respectively. Conclusions: Both Hemphill ICH and GVS score have comparable predicting ability of outcome in ICH. In addition to components of scoring systems, occurrence of nosocomial pneumonia and blood glucose seems important. Journal of National Institute of Neurosciences Bangladesh, January 2021, Vol. 7, No. 1, pp. 3-9

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Section: Discussionsupporting

confidence: 86%

Predictors of Outcome in Intracerebral Hemorrhage and Performance of Hemphill ICH Score and GVS Score

Islam

Hasan

Mukherjee

et al. 2021

J. Natl Inst. Neurosci Bangladesh

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“…So, external validation to determine whether the ICH score could accurately risk-stratify patients in a cohort independent of that from which it was developed was done in different population. Till date several studies in abroad have shown the external validity of ICH score but the study population and the hospital settings were completely different from ours 6,[9][10][11][12][13][14] . Published study on ICH score in Bangladesh is very limited and the external validity of ICH score is not aimed in any study yet.…”

contrasting

confidence: 58%

Prognostic significance of Intracerebral Hemorrhage Score in predicting 30-day mortality in Chittagong Medical College Hospital

Emran

Hassanuzzaman

Majumder

et al. 2019

Bangla. J. Neuroscience

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Background:Prognosticating the outcome of Intracerebral Hemorrhage (ICH) at the time of admission is important to customize treatment in a cost-effective manner in such cases. ICH sore is a widely used prognosticating tool but yet not evaluated in our setting. This study was aimed to assess the prognostic factors influencing outcome and validating the ICH score for prediction of 30-day mortalityin hospitalized patients with ICH. Materials and methods:This prospective observational study was conducted in Chittagong Medical College Hospital, Bangladesh among 105 consecutively admitted patients aged 18 years and above with a computed tomography evidence of spontaneous ICH. ICH score was calculated soon after confirmation of diagnosis. Primary outcome measure was 30-day mortality after admission. Modified Rankin Scale (mRS) was used to assess outcome at discharge and at 30-day follow up. Results:A total of 104 patients were analyzed. Mean age of this cohort was 59.30±19.91 years. At 30 days all 27 patients with an ICH score of 0 survived, whereas those having scores of 1, 2, 3, and 4 had 5.9%, 33.3%, 46.2% and 88.9% mortality, respectively. ICH score was good for discriminating 30-day mortality with having an area under the ROC curve of 0.886 (95% CI:0.816-0.956; p<0.001]. For patients scoring above 2, the rate of poor functional outcome (mRS score e”4) approaches 100%. On the other hand, 18.5% of patients with score of 0 and 64.7% of patients with a score of 1 are not functionally independent after 30 days. Conclusion:In conclusion, the present study has demonstrated that the ICH score is a strong prognostic indicator of ICH outcomes (30-day mortality and 30- day functional outcome) among hospitalized patients in Bangladesh. Bangladesh Journal of Neuroscience 2019; Vol. 35 (2): 78-85

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“…We realized 05 publications from the MURTI trainees in this area: (i) PMC5659749; 34 (ii) PMC7341388; 35 (iii) PMC6716529; 36 (iv) PMC8276422; 37 (v) PMC6309793. 38 Mental health research area. We realized 09 publications from the MURTI trainees in this area: (i) PMC6036650; 39 (ii) PMC5411062; 40 (iii) PMC6289958; 41 (iv) PMC6774805; 42 (v) PMC6613367; 43 (vi) PMC5423027; 44 (vii) PMC6614012; 20 (viii) PMC7750070; 45 (ix) 10.11604/pamj-oh.2020.3.9.25146.…”

Section: Resultsmentioning

confidence: 99%

“…We realized 05 publications from the MURTI trainees in this area: (i) PMC5659749; 34 (ii) PMC7341388; 35 (iii) PMC6716529; 36 (iv) PMC8276422; 37 (v) PMC6309793. 38 …”

Section: Resultsmentioning

confidence: 99%

Mbarara University Research Training Initiative: Experiences and Accomplishments of the MEPI Junior D43 TW010128 Award in Uganda

Wakida¹,

Atuhaire²,

Karungi³

et al. 2021

AMEP

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Objective In 2015, Mbarara University of Science and Technology was awarded the Mbarara University Research Training Initiative (MURTI) under grant number D43 TW010128 to build capacity of junior faculty to become the next generation of researchers in Africa. In this paper, we document the experiences and achievements of the research capacity building efforts at MUST. Methods We conducted a descriptive evaluation study which involved document review and in-depth interviews. We used “Reach” and ‘Effectiveness’ from the RE-AIM framework to guide the document review, and the organizational theory of implementation effectiveness to guide the in-depth interviews. Results In the MURTI program, we conducted 17 short courses between August 2015 and July 2021, a total of 6597 attendances were recorded. The most attended courses were responsible conduct of research (n = 826), qualitative research methods (n = 744), and data management (n = 613). Thirty-three fellows were recruited and funded to conduct mentored research leading to 48 publications and 14 extramural grant applications were yielded. From the in-depth interviews, the participants appreciated the research training program, the enhanced research skills attained, and the institutional capacity built. They attributed the success of the program to the training approach of using short courses, readiness of the junior faculty to change, and the supportive environment by the mentors and trainers in the program. Conclusion The D43 TW010128 research training grant-built capacity for the junior faculty at MUST, enhanced their research skills, promoted research capacity institutionally and provided career development for the junior faculty. This was possible due to the positive attitude of the junior faculty (organizational readiness) to change and the supportive environment (mentors and trainers) during implementation of the grant. These two factors provided a favorable institutional climate that guaranteed success of the funding goals.

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Validation of the Intracerebral Hemorrhage Score in Uganda

Cited by 6 publications

References 14 publications

Predictors of Outcome in Intracerebral Hemorrhage and Performance of Hemphill ICH Score and GVS Score

Predictors of Outcome in Intracerebral Hemorrhage and Performance of Hemphill ICH Score and GVS Score

Prognostic significance of Intracerebral Hemorrhage Score in predicting 30-day mortality in Chittagong Medical College Hospital

Mbarara University Research Training Initiative: Experiences and Accomplishments of the MEPI Junior D43 TW010128 Award in Uganda

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