QJM Advance Access first published online on October 9, 2006
This version published online on October 17, 2006
QJM, doi:10.1093/qjmed/hcl107
| ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
1 From the Division of General Internal Medicine, Department of Medicine, St Luke's International Hospital, Tokyo, Japan
* To whom correspondence should be addressed. 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.
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
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
O. Takahashi, E-mail: bur-kyt{at}umin.ac.jp
Abstract 
CiteULike 
Connotea 
Del.icio.us What's this?
This article has been cited by other articles:
|
|
 |
|
  Y. P. Tabak, X. Sun, R. S. Johannes, V. Gupta, and A. F. Shorr Mortality and Need for Mechanical Ventilation in Acute Exacerbations of Chronic Obstructive Pulmonary Disease: Development and Validation of a Simple Risk Score Arch Intern Med, September 28, 2009; 169(17): 1595 - 1602. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 B U Wu, R S Johannes, X Sun, Y Tabak, D L Conwell, and P A Banks The early prediction of mortality in acute pancreatitis: a large population-based study Gut, December 1, 2008; 57(12): 1698 - 1703. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 N. S. Rost, E. E. Smith, Y. Chang, R. W. Snider, R. Chanderraj, K. Schwab, E. FitzMaurice, L. Wendell, J. N. Goldstein, S. M. Greenberg, et al. Prediction of Functional Outcome in Patients With Primary Intracerebral Hemorrhage: The FUNC Score Stroke, August 1, 2008; 39(8): 2304 - 2309. [Abstract] [Full Text] [PDF]
|
|