• World Neurosurg · Jul 2022

    Correlation of scoring systems with the requirement of an external ventricular drain in intraventricular hemorrhage.

    • Yoshinori Maki, Ryota Ishibashi, Takaya Yasuda, Hironobu Tokumasu, Yoshiharu Yamamoto, Akio Goda, Hokuto Yamashita, Takumi Morita, Hiroyuki Ikeda, Masaki Chin, and Sen Yamagata.
    • Department of Neurosurgery, Kurashiki Central Hospital, Kurashiki, Japan. Electronic address: passatempo19840816@gmail.com.
    • World Neurosurg. 2022 Jul 1; 163: e532-e538.

    BackgroundExternal ventricular drainage (EVD) is required to resolve acute hydrocephalus associated with intraventricular hemorrhage (IVH). The correlation of scoring systems of IVH with indications for EVD for acute hydrocephalus related to IVH is currently unknown.MethodsWe identified 213 hypertensive patients with IVH and divided them into 2 groups according to treatment method: 187 patients receiving blood pressure control alone and 26 patients undergoing EVD. The following patients were excluded: pediatric patients, patients undergoing intracranial hematoma removal, patients with fetal status, and patients without sufficient clinical data. We compared the Glasgow Coma Scale score, Graeb score, LeRoux score, Evans index, and bicaudate index values between the 2 groups and determined the prognostication accuracy of each scoring system.ResultsThere were significant differences in all 4 scoring systems between the 2 groups (P < 0.001). The cutoff values (sensitivity and specificity) of each scoring system were as follows: Glasgow Coma Scale, 8 (65.4%, 87.7%); Graeb score, 6 (80.8%, 75.4%); LeRoux score, 9 (80.8%, 76.5%); Evans index, 0.245 (80.8%, 67.9%); and bicaudate index, 0.186 (76.9%, 76.5%). The value of the area under the curve of each scoring system (95% confidence interval) was as follows: Glasgow Coma Scale, 0.806 (0.705-0.907); Graeb score, 0.852 (0.779-0.925); LeRoux score, 0.875 (0.812-0.937); Evans index, 0.788 (0.702-0.875); and bicaudate index, 0.778 (0.673-0.883).ConclusionsThe LeRoux score is better for identifying patients with IVH who are more likely to have EVD.Copyright © 2022 Elsevier Inc. All rights reserved.

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