Utilize este identificador para referenciar este registo: http://hdl.handle.net/10451/20403
Título: Risk score to predict the outcome of patients with cerebral vein and dural sinus thrombosis
Autor: Ferro, José
Bacelar-Nicolau, Helena
Rodrigues, Teresa
Bacelar-Nicolau, Leonor
Canhão, Patrícia
Crassard, Isabelle
Bousser, Marie-Germaine
Dutra, Aurélio Pimenta
Massaro, Ayrton
Mackowiack-Cordiolani, Marie-Anne
Leys, Didier
Fontes, João
Stam, Jan
Barinagarrementeria, Fernando
Palavras-chave: Dural sinus
Cerebral vein thrombosis
Outcome
Validation
Risk score
Data: 2009
Editora: Karger
Citação: Cerebrovasc Dis 2009;28:39–44
Resumo: BACKGROUND: Around 15% of patients die or become dependent after cerebral vein and dural sinus thrombosis (CVT). METHOD: We used the International Study on Cerebral Vein and Dural Sinus Thrombosis (ISCVT) sample (624 patients, with a median follow-up time of 478 days) to develop a Cox proportional hazards regression model to predict outcome, dichotomised by a modified Rankin Scale score >2. From the model hazard ratios, a risk score was derived and a cut-off point selected. The model and the score were tested in 2 validation samples: (1) the prospective Cerebral Venous Thrombosis Portuguese Collaborative Study Group (VENOPORT) sample with 91 patients; (2) a sample of 169 consecutive CVT patients admitted to 5 ISCVT centres after the end of the ISCVT recruitment period. Sensitivity, specificity, c statistics and overall efficiency to predict outcome at 6 months were calculated. RESULTS: The model (hazard ratios: malignancy 4.53; coma 4.19; thrombosis of the deep venous system 3.03; mental status disturbance 2.18; male gender 1.60; intracranial haemorrhage 1.42) had overall efficiencies of 85.1, 84.4 and 90.0%, in the derivation sample and validation samples 1 and 2, respectively. Using the risk score (range from 0 to 9) with a cut-off of >or=3 points, overall efficiency was 85.4, 84.4 and 90.1% in the derivation sample and validation samples 1 and 2, respectively. Sensitivity and specificity in the combined samples were 96.1 and 13.6%, respectively. CONCLUSIONS: The CVT risk score has a good estimated overall rate of correct classifications in both validation samples, but its specificity is low. It can be used to avoid unnecessary or dangerous interventions in low-risk patients, and may help to identify high-risk CVT patients.
Descrição: This study was supported by grants from the ‘Fundação para a Ciência e Tecnologia’ (PRAXIS C/SAU/10248/1998) and the ‘Associação para o Desenvolvimento da Investigação da Doença Vascular Cerebral’.
Peer review: yes
URI: http://hdl.handle.net/10451/20403
DOI: http://dx.doi.org/10.1159/000215942
ISSN: 1015-9770
Versão do Editor: http://www.karger.com/Article/Abstract/215942
Aparece nas colecções:FM-IMP-Artigos em Revistas Internacionais

Ficheiros deste registo:
Ficheiro Descrição TamanhoFormato 
risk_score.pdf131,19 kBAdobe PDFVer/Abrir    Acesso Restrito. Solicitar cópia ao autor!


FacebookTwitterDeliciousLinkedInDiggGoogle BookmarksMySpace
Formato BibTex MendeleyEndnote Degois 

Todos os registos no repositório estão protegidos por leis de copyright, com todos os direitos reservados.