Citations 1
Accuracy of the ABC/2 Score for Intracerebral Hemorrhage
Webb, Alastair J.S. , Ullman, Natalie , Morgan, Tim C., Muschelli, John , Kornbluth, Joshua , Awad, Issam A. , Rosenblum, Michael , Ziai, Wendy , Zuccarrello, Mario, Aldrich, François, John, Sayona , Harnof, Sagi , Lopez, George Α. , Broaddus, William C. , Wijman, Christine A.C., Vespa, Paul , Bullock, Ross, Haines, Stephen J. , Cruz‐Flores, Salvador , Tuhrim, Stan, Hill, Michael D. , Narayan, Raj K. , Hanley, Daniel F. , Tayal, Ashis , Díaz, Alberto Torres, Hoffer, Alan , Moheet, Asma , Agarwal, Sachin , Markowski, Mason, Rosenthal, Guy , Kureshi, Inam, Varelas, Panayiotis N. , Pinto, Pedro Telles Cougo, Camarata, Paul J. , Helms, Ann , Shahi, Kavian, Sinclair, David, Gizzi, Martin , LeDoux, David, Torbey, Michel , Cockroft, Kevin M. , Antezana, David, Margalit, Nevo, Crabtree, H. Mark, Lovick, Darren, Weaver, Michael, Leonardo, Jody, Ardelt, Agnieszka, Csiba, László , Wartenberg, Katja E. , Bösel, Julian , Adams, Harold P. , Hobohm, Carsten , Kerz, Thomas , Wechsler, Lawrence R. , Gardner, Paul A. , Decker, David A., Gonzales, Nicole R. , Caron, Jean-Louis, Hall, Christiana E., Ansari, Safdar , Luft, Andreas R. , Graham, R. Scott, Tucker, Kristi, Webb, Alastair Js , Mayo, Stephen L. , Martí‐Fábregas, Joan , Seder, David B. , Freeman, William D. , Lazaridis, Christos , LeDoux, David, Latorre, Julius Gene , Venkatasubramanian, Chitra , Jallo, Jack , Reinert, Michael , Butcher, Kenneth , Adeoye, Opeolu M , Testai, Fernando D. , Bulters, Diederik , Caron, Jean-Louis R., Arikán, Fuat , Hill, Michael D , Hanley, Daniel F , Lopez, George
Stroke | August 5, 2015 | Volume: 46 | Issue: 9 | Pages: 2470-2476
Background and Purpose— The ABC/2 score estimates intracerebral hemorrhage (ICH) volume, yet validations have been limited by small samples and inappropriate outcome measures. We determined accuracy of the ABC/2 score calculated at a specialized reading center (RC-ABC) or local site (site-ABC) versus the reference-standard computed tomography–based planimetry (CTP). Methods— In Minimally Invasive Surgery Plus Recombinant Tissue-Type Plasminogen Activator for Intracerebral Hemorrhage Evacuation-II (MISTIE-II), Clot Lysis Evaluation of Accelerated Resolution of Intraventricular Hemorrhage (CLEAR-IVH) and CLEAR-III trials. ICH volume was prospectively calculated by CTP, RC-ABC, and site-ABC. Agreement between CTP and ABC/2 was defined as an absolute difference up to 5 mL and relative difference within 20%. Determinants of ABC/2 accuracy were assessed by logistic regression. Results— In 4369 scans from 507 patients, CTP was more strongly correlated with RC-ABC ( r 2 =0.93) than with site-ABC ( r 2 =0.87). Although RC-ABC overestimated CTP-based volume on average (RC-ABC, 15.2 cm 3 ; CTP, 12.7 cm3), agreement was reasonable when categorized into mild, moderate, and severe ICH (κ=0.75; P <0.001). This was consistent with overestimation of ICH volume in 6 of 8 previous studies. Agreement with CTP was greater for RC-ABC (84% within 5 mL; 48% of scans within 20%) than for site-ABC (81% within 5 mL; 41% within 20%). RC-ABC had moderate accuracy for detecting ≥5 mL change in CTP volume between consecutive scans (sensitivity, 0.76; specificity, 0.86) and was more accurate with smaller ICH, thalamic hemorrhage, and homogeneous clots. Conclusions— ABC/2 scores at local or central sites are sufficiently accurate to categorize ICH volume and assess eligibility for the CLEAR-III and MISTIE III studies and moderately accurate for change in ICH volume. However, accuracy decreases with large, irregular, or lobar clots. Clinical Trial Registration— URL: http://www.clinicaltrials.gov . Unique identifier: MISTIE-II NCT00224770; CLEAR-III NCT00784134.