Skip Navigation


QJM Advance Access first published online on October 9, 2006
This version published online on October 17, 2006
QJM, doi:10.1093/qjmed/hcl107
This Article
Right arrow FREE Full Text (PDF) Freely available
Right arrow All Versions of this Article:
99/11/743    most recent
hcl107v2
hcl107v1
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My Personal Archive
Right arrow Download to citation manager
Right arrowRequest Permissions
Right arrow Disclaimer
Google Scholar
Right arrow Articles by Takahashi, O.
Right arrow Articles by Fukui, T.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Takahashi, O.
Right arrow Articles by Fukui, T.
Social Bookmarking
Add to CiteULike   Add to Connotea   Add to Del.icio.us  
What's this?

© The Author 2006. Published by Oxford University Press on behalf of the Association of Physicians. All rights reserved. For Permissions, please email: Journals.permissions@oxfordjournals.org
Received October 9, 2005
Accepted June 18, 2006

Original Papers

Risk stratification for in-hospital mortality in spontaneous intracerebral haemorrhage: A Classification and Regression Tree Analysis

O. Takahashi 1 *, E.F. Cook 2, T. Nakamura 3, J. Saito 4, F. Ikawa 5, and T. Fukui 1

1 From the Division of General Internal Medicine, Department of Medicine, St Luke's International Hospital, Tokyo, Japan
2 From the Division of General Internal Medicine and Primary Care, Brigham and Women's Hospital, Boston, Massachusetts
3 From the Departments of General Medicine, Shimane Prefectural Central Hospital, Izumo, Japan
4 From the Neurology, Shimane Prefectural Central Hospital, Izumo, Japan
5 From the Neurosurgery, Shimane Prefectural Central Hospital, Izumo, Japan

* To whom correspondence should be addressed.
O. Takahashi, E-mail: bur-kyt{at}umin.ac.jp


  Abstract

Background: Risk stratification for mortality in intracerebral haemorrhage (ICH) helps guide care, but existing clinical prediction rules are too cumbersome for clinical practice because of their complexity.

Aim: To develop a simple decision tree model of in-hospital mortality risk stratification for ICH patients.

Methods: We collected information on spontaneous ICH patients hospitalized in a teaching hospital in Japan from August, 1998 to December, 2001 (n = 374). All variables were abstracted from data available at the time of initial evaluation. A prediction rule for in-hospital mortality was developed by the Classification and Regression Tree (CART) methodology. The accuracy of the model was evaluated using the area under receiver-operator characteristic curve.

Results: Overall in-hospital mortality rate was 20.2%. The CART methodology identified four groups for mortality risk, varying from low (2.1%) to high (58.9%). Level of consciousness (coma) was the best single predictor for mortality, followed by high ICH volume (cut-off 10.4 ml), and then age (cut-off 75 years). The accuracy of our CART model (0.86) exceeded that of a multivariate logistic regression model (0.81).

Discussion: ICH patients can easily be stratified for mortality risk, based on three predictors available on admission. This simple decision tree model provides clinicians with a reliable and practical tool.


Add to CiteULike CiteULike   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us    What's this?




Disclaimer:
Please note that abstracts for content published before 1996 were created through digital scanning and may therefore not exactly replicate the text of the original print issues. All efforts have been made to ensure accuracy, but the Publisher will not be held responsible for any remaining inaccuracies. If you require any further clarification, please contact our Customer Services Department.