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Master Thesis

Élaboration d’un score radio-clinique prédictif de l’évolution neurologique après rupture de malformation artério-veineuse cérébrale

Abstract : Background and Purpose: Brain arteriovenous malformations (BAVMs) are a leading cause of intracranial hemorrhage in young adults. We aimed to design a scale predictive of neurological outcome after BAVM rupture. Materials and Methods: 135 patients with 139 BAVM rupture events were included. Independent predictors of long-term poor outcome (modified Rankin scale [mRS] > 3 more than one year after admission) were identified. A risk stratification scale was developed and compared to the intracerebral hemorrhage (ICH) score to predict poor outcome and delta-mRS (difference between follow-up and baseline pre-hemorrhage mRS). The score was also compared to the ICH score for prediction of in-hospital mortality. Results: Multivariate logistic regression analysis determined that consciousness level (odd ratio [OR] 6.5, 95% confidence interval (CI) [3.09-13.7], P-value<10-3), hematoma volume (OR 1.84, 95%CI [1.21-2.8], P-value=0.005) and intraventricular hemorrhage (OR 7.46, 95%CI [2.66-21], P-value<10-3) were independently associated with poor outcome. A 12-scale (0 to 11) simplified score for ruptured BAVM prognostication was constructed combining these criteria. This new score was a stronger predictor of long-term poor outcome (P-value=0.009). The score was also a stronger predictor of delta-mRS and in-hospital mortality. Conclusion: We propose a new admission score (the Ruptured AVM Prognostic Score [RAPS]) dedicated to stratifying the risk of poor long-term outcome after BAVM rupture.
Document type :
Master Thesis
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https://dumas.ccsd.cnrs.fr/dumas-01302379
Contributor : Université Paris Descartes - Scd <>
Submitted on : Thursday, April 14, 2016 - 10:44:44 AM
Last modification on : Wednesday, August 19, 2020 - 11:18:09 AM
Long-term archiving on: : Friday, July 15, 2016 - 12:02:35 PM

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  • HAL Id : dumas-01302379, version 1

Citation

Eimad Shotar. Élaboration d’un score radio-clinique prédictif de l’évolution neurologique après rupture de malformation artério-veineuse cérébrale. Médecine humaine et pathologie. 2015. ⟨dumas-01302379⟩

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