Development and validation of a new score for predicting functional outcome of neurocritically ill patients: The INCNS score.

Abstract:

AIMS:To develop and validate a novel score for prediction of 3-month functional outcome in neurocritically ill patients. METHODS:The development of the novel score was based on two widely used scores for general critical illnesses (Acute Physiology and Chronic Health Evaluation II, APACHE II; Simplified Acute Physiology Score II, SAPS II) and consideration of the characteristics of neurocritical illness. Data from consecutive patients admitted to neurological ICU (N-ICU) between January 2013 and June 2016 were used for the validation. The modified Rankin Scale (mRS) was used to evaluate 3-month functional outcomes. APACHE II scores, SAPS II scores, and our novel scores at 24 hours and 72 hours in N-ICU were obtained. We compared the prognostic performance of our score with APACHE II and SAPS II. RESULTS:We developed a 44-point scoring system named the INCNS score, and it includes 19 items which were categorized into five parts: inflammation (I), nutrition (N), consciousness (C), neurological function (N), and systemic function (S). We validated the INCNS score with a cohort of 941 N-ICU patients. The 72-hours INCNS score achieved an area under the receiver operating characteristic curve (AUC) of 0.828 (95% CI: 0.802-0.854), and the 24-hours INCNS score achieved an AUC of 0.788 (95% CI: 0.759-0.817). The INCNS score exhibited significantly better discriminative and prognostic performance than APACHE II and SAPS II at both 24 hours and 72 hours in N-ICU. CONCLUSION:We developed an INCNS score with superior predictive power for functional outcome of neurocritically ill patients.

journal_name

CNS Neurosci Ther

authors

Gao Q,Yuan F,Yang XA,Zhu JW,Song L,Bi LJ,Jiao ZY,Kang XG,Yang F,Jiang W

doi

10.1111/cns.13134

subject

Has Abstract

pub_date

2020-01-01 00:00:00

pages

21-29

issue

1

eissn

1755-5930

issn

1755-5949

journal_volume

26

pub_type

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