A simple prediction score system for malignant brain edema progression in large hemispheric infarction.

Malignant brain edema (MBE) due to hemispheric infarction can result in brain herniation, poor outcomes, and death; outcome may be improved if certain interventions, such as decompressive craniectomy, are performed early. We sought to generate a prediction score to easily identify those patients at...

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Main Authors: KwangWook Jo, Suhas S Bajgur, Hoon Kim, Huimahn A Choi, Pil-Woo Huh, Kiwon Lee
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2017-01-01
Series:PLoS ONE
Online Access:https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0171425&type=printable
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author KwangWook Jo
Suhas S Bajgur
Hoon Kim
Huimahn A Choi
Pil-Woo Huh
Kiwon Lee
author_facet KwangWook Jo
Suhas S Bajgur
Hoon Kim
Huimahn A Choi
Pil-Woo Huh
Kiwon Lee
author_sort KwangWook Jo
collection DOAJ
description Malignant brain edema (MBE) due to hemispheric infarction can result in brain herniation, poor outcomes, and death; outcome may be improved if certain interventions, such as decompressive craniectomy, are performed early. We sought to generate a prediction score to easily identify those patients at high risk for MBE. 121 patients with large hemispheric infarction (LHI) (2011 to 2014) were included. Patients were divided into two groups: those who developed MBE and those who did not. Independent predictors of MBE were identified by logistic regression and a score was developed. Four factors were independently associated with MBE: baseline National Institutes of Health Stroke Scale (NIHSS) score (p = 0.048), Alberta Stroke Program Early Computed Tomography Score (ASPECTS) (p = 0.007), collateral score (CS) (p<0.001) and revascularization failure (p = 0.013). Points were assigned for each factor as follows: NIHSS ≤ 8 (= 0), 9-17 (= 1), ≥ 18 (= 2); ASPECTS≤ 7 (= 1), >8 (= 0); CS<2 (= 1), ≥2 (= 0); revascularization failure (= 1),success (= 0). The MBE Score (MBES) represents the sum of these individual points. Of 26 patients with a MBES of 0 to 1, none developed MBE. All patients with a MBES of 6 developed MBE. Both MBE development and functional outcomes were strongly associated with the MBES (p = 0.007 and 0.002, respectively). The MBE score is a simple reliable tool for the prediction of MBE.
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spelling doaj-art-b8cf8db2564a444094f423f23cfdfcee2025-08-20T02:03:58ZengPublic Library of Science (PLoS)PLoS ONE1932-62032017-01-01122e017142510.1371/journal.pone.0171425A simple prediction score system for malignant brain edema progression in large hemispheric infarction.KwangWook JoSuhas S BajgurHoon KimHuimahn A ChoiPil-Woo HuhKiwon LeeMalignant brain edema (MBE) due to hemispheric infarction can result in brain herniation, poor outcomes, and death; outcome may be improved if certain interventions, such as decompressive craniectomy, are performed early. We sought to generate a prediction score to easily identify those patients at high risk for MBE. 121 patients with large hemispheric infarction (LHI) (2011 to 2014) were included. Patients were divided into two groups: those who developed MBE and those who did not. Independent predictors of MBE were identified by logistic regression and a score was developed. Four factors were independently associated with MBE: baseline National Institutes of Health Stroke Scale (NIHSS) score (p = 0.048), Alberta Stroke Program Early Computed Tomography Score (ASPECTS) (p = 0.007), collateral score (CS) (p<0.001) and revascularization failure (p = 0.013). Points were assigned for each factor as follows: NIHSS ≤ 8 (= 0), 9-17 (= 1), ≥ 18 (= 2); ASPECTS≤ 7 (= 1), >8 (= 0); CS<2 (= 1), ≥2 (= 0); revascularization failure (= 1),success (= 0). The MBE Score (MBES) represents the sum of these individual points. Of 26 patients with a MBES of 0 to 1, none developed MBE. All patients with a MBES of 6 developed MBE. Both MBE development and functional outcomes were strongly associated with the MBES (p = 0.007 and 0.002, respectively). The MBE score is a simple reliable tool for the prediction of MBE.https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0171425&type=printable
spellingShingle KwangWook Jo
Suhas S Bajgur
Hoon Kim
Huimahn A Choi
Pil-Woo Huh
Kiwon Lee
A simple prediction score system for malignant brain edema progression in large hemispheric infarction.
PLoS ONE
title A simple prediction score system for malignant brain edema progression in large hemispheric infarction.
title_full A simple prediction score system for malignant brain edema progression in large hemispheric infarction.
title_fullStr A simple prediction score system for malignant brain edema progression in large hemispheric infarction.
title_full_unstemmed A simple prediction score system for malignant brain edema progression in large hemispheric infarction.
title_short A simple prediction score system for malignant brain edema progression in large hemispheric infarction.
title_sort simple prediction score system for malignant brain edema progression in large hemispheric infarction
url https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0171425&type=printable
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