Abstract 211: Subjective Judgments of Physicians and Nurses Are More Accurate Than Formal Clinical Scales in Predicting Functional Outcome After Intracerebral Hemorrhage
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Introduction: Providing an accurate prognosis is a fundamental responsibility of care providers for patients with intracerebral hemorrhage (ICH). The ICH and FUNC Scores are common clinical scales designed to predict functional outcome and mortality for ICH patients. Hypothesis: The ICH Score and FUNC Score have superior accuracy, compared to the early clinical judgment of physicians and nurses, with regards to the prediction of the Modified Rankin Scale (mRS) achieved by ICH patients at 3 months. Methods: We conducted a prospective study at 5 centers. For each consecutive adult patient admitted with primary ICH, one physician and one nurse on the treatment team were asked for prediction of mRS at 3 months. All predictions were collected within 24 hours of admission. ICH and FUNC Scores on admission and blinded outcome at 3 months were obtained for each patient, in part using data collected for the ongoing Ethnic/Racial Variations with ICH (ERICH) project. Predictive ability was measured by Spearman’s rank correlation (r). Results: For a total of 100 patients, 100 physicians (75 attendings, 25 trainees) and 100 nurses gave predictions. In order of strength of association with actual 3-month mRS, correlations were attending physicians r = 0.81, nurses r = 0.72, and trainees r = 0.66. Although suggestive, none of these groups were statistically superior (p > 0.10). However, nurses (p = 0.015) and attending physicians (p = 0.002), but not trainees (p = 0.57), were superior in their predictive ability over ICH Score (r = 0.55). Similarly, nurses (p = 0.0003) and attending physicians (p < 0.0001), but not trainees (p = 0.27), were superior over FUNC Score (r = -0.46). This accuracy advantage remained when examining predictions for (1) only those patients alive at 3 months (n = 65), and (2) only those patients for whom providers indicated that they would not recommend comfort care within the first 24 hours (n = 82). Conclusions: The ICH Score and FUNC Score did not have superior accuracy, compared to subjective clinical judgment, with regards to prediction of 3-month ICH outcome.
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Le contrôle bibliographique ouvert
DOI retrouvé dans Crossref DOI retrouvé ; titre concordant.
- Titre Crossref
- Abstract 211: Subjective Judgments of Physicians and Nurses Are More Accurate Than Formal Clinical Scales in Predicting Functional Outcome After Intracerebral Hemorrhage
- Date Crossref
- 01/02/2014
- Éditeur
- Ovid Technologies (Wolters Kluwer Health)
- Type
- journal-article
Ce recoupement confirme des métadonnées liées au DOI. Il ne confirme ni la méthode ni les conclusions de l’étude, et il ne compte pas comme une seconde source scientifique indépendante.
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Yale University pays non établi dans la noticeUniversité ou école supérieure
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University of Maryland pays non établi dans la noticeUniversité ou école supérieure
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Wake Forest University pays non établi dans la noticeUniversité ou école supérieure
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Yale University, University of Maryland et Wake Forest University, avec 9 autres affiliations.
Une affiliation ne permet pas de déduire la nationalité d’un auteur.