gms | German Medical Science

68th Annual Meeting of the German Society of Neurosurgery (DGNC)
7th Joint Meeting with the British Neurosurgical Society (SBNS)

German Society of Neurosurgery (DGNC)

14 - 17 May 2017, Magdeburg

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International Multicenter Validation of the Arteriovenous Malformation Related Intracerebral Hemorrhage (AVICH) Score

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  • Marian Christoph Neidert - University Hospital Zurich, Department of Neurosurgery, Zürich, Switzerland
  • Michael T Lawton - San Francisco, United States
  • Luca Regli - UniversitätsSpital Zürich , Klinik für Neurochirurgie, Zürich, Switzerland
  • Jan-Karl Burkhardt - Zürich, Switzerland
  • Oliver Bozinov - Klinik für Neurochirurgie, Universitätsspital Zürich, Zürich, Switzerland

Deutsche Gesellschaft für Neurochirurgie. Society of British Neurological Surgeons. 68. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), 7. Joint Meeting mit der Society of British Neurological Surgeons (SBNS). Magdeburg, 14.-17.05.2017. Düsseldorf: German Medical Science GMS Publishing House; 2017. DocDI.11.05

doi: 10.3205/17dgnc239, urn:nbn:de:0183-17dgnc2392

Published: June 9, 2017

© 2017 Neidert et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at http://creativecommons.org/licenses/by/4.0/.

Outline

Text

Objective: The recently published AVICH score showed a better outcome prediction for patients with arteriovenous malformation (AVM) related intracerebral hemorrhage (ICH) than other AVM or ICH scores. Here we present the results of a multicenter, external validation of the AVICH score.

Methods: All participating centers from the USA (n=3), Europe (n=4) and Japan (n=3) provided anonymous data sets to validate the AVICH score. Besides parameters needed to form the Spetzler-Martin (SM) grade, the supplemented SM (sSM) grade, the ICH score and the AVICH score, modified Rankin score (mRS) at last follow-up (mean 25.6 months) were retrospectively collected and analyzed. Patient outcome was dichotomized into favorable (mRS 0-2) and unfavorable (mRS 3-6). Univariate analysis and AUROC analysis were performed to validate the AVICH score.

Results: A total of 385 patients with AVM related ICH were included. Except nidus structure and AVM size, all single parameters forming the SM, sSM, ICH and AVICH score and the scores itself were significantly different between both outcome groups in the univariate analysis. The AVICH score was confirmed to be the highest predictive outcome score with an AUROC of 0.732 compared to 0.616 for the sSM grade, 0.665 for the ICH score and 0.581 for the SM grade.

Conclusion: We were able to confirm that the AVICH score predicts clinical outcome of patients with ruptured AVM and associated ICH and is far superior compared to the other scores. We suggest the routine use of this score for clinical outcome prediction and for usage in clinical research.