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首页> 外文期刊>Journal of stroke and cerebrovascular diseases: The official journal of National Stroke Association >Vision, Aphasia, Neglect Assessment to Predict Neurosurgical Intervention in Patients with Nontraumatic Intracerebral Hemorrhage
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Vision, Aphasia, Neglect Assessment to Predict Neurosurgical Intervention in Patients with Nontraumatic Intracerebral Hemorrhage

机译：视觉，失语症，疏忽评估预测非吸引性脑出血患者的神经外科干预

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Background and Purpose: The Vision, Aphasia, and Neglect (VAN) screening tool is a simple bedside test developed to identify patients with large vessel occlusion stroke. In the setting of intracerebral hemorrhage (ICH), there are very few bedside predictors of need for neurosurgical interventions other than age and Glasgow Coma Scale (GCS). We aimed to assess the utility of the VAN screening tool in predicting the need for neurosurgical intervention in patients with ICH. Methods: We accessed sensitivity, specificity, positive predictive value, negative predictive value (NPV), and area under receiver operating characteristics curve of VAN for identifying ICH patients who require neurosurgical intervention. Results: Among 228 ICH patients, 176 were VAN positive and 52 were VAN negative. On unadjusted analyses, VAN positive patients had a significantly higher ICH volume, GCS score, and National Institutes of Health Stroke Scale score (P < .001 for all). As compared to VAN negative patients, significantly higher proportion of VAN positive ICH patients (15.4% versus 32.4%) underwent a neurosurgical procedure such as external ventricular drain (EVD) and/ or hematoma evacuation with craniotomy or craniectomy. The VAN screening tool had high sensitivity and NPV (100%) in predicting the need for craniectomy or hematoma evacuation, but had lower sensitivity (87.7%) for any neurosurgical procedure, as 15.4% of VAN negative patients received EVD. Conclusions: Our study suggests that VAN screening tool can identify high-risk ICH patients who are more likely to undergo craniotomy or craniectomy but is less sensitive to rule out need for EVD.
机译：背景和目的：视觉，失语症和忽视（VAN）筛选工具是一种简单的床头段测试，用于鉴定大血管闭塞行程的患者。在脑内出血（ICH）的设置中，床边有需要的是，除了年龄和Glasgow Coma Scale（GCS）以外的神经外科干预需要。我们旨在评估面包车筛查工具的效用，以预测ICH患者的神经外科干预需要。方法：进入敏感性，特异性，阳性预测值，负预测值（NPV），以及面包车接收器操作特性曲线下的面积，用于识别需要神经外科干预的ICH患者。结果：228名患者中，176名是Van阳性，52架是面包片负面。在不调整的分析上，van阳性患者的ICH患者具有明显更高的ICH体积，GCS评分和国家卫生冲程量表得分（全部P <.001）。与面包片阴性患者相比，van阳性ICH患者的比例显着更高（15.4％，而32.4％）接受了神经外科手术，例如外部心室排水（EVD）和/或血肿疏散，用Craniotomy或Craniectomy脱落。 VAR筛查工具具有高灵敏度和NPV（100％），以预测颅骨切除或血肿疏散的需要，但具有较低的敏感性（87.7％）对于任何神经外科手术的敏感性（87.7％），为15.4％的范负患者接受EVD。结论：我们的研究表明，面包车筛查工具可以识别高风险的ICH患者，这些患者更有可能接受颅骨切割或颅骨切除术，但对EVD的需求不太敏感。

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