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Sof index

1 vote

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How about the FRESH score?

SUMMARY AND COMMENT | STROKE
June 28, 2016

A Better Way to Prognosticate Outcomes After Subarachnoid Hemorrhage
Hooman Kamel, MD Reviewing Witsch J et al., Ann Neurol 2016 Apr 30;
The FRESH score provides more-reliable predictions than the Hunt and Hess score alone.

The Hunt & Hess (HH) score is often used to prognosticate about neurological recovery after subarachnoid hemorrhage (SAH), but many patients with high HH scores will nevertheless recover well. To develop a more sophisticated prognostication score, researchers used a prospective registry of more than 1500 SAH patients at a single tertiary-care center between 1996 and 2014 to identify clinical, imaging, and laboratory parameters that best predicted neurological recovery 12 months after SAH.

The identified best prognostic factors were age, HH score, APACHE-II physiologic score, and aneurysmal rebleeding within 48 hours after admission. The researchers used these parameters to develop the Functional Recovery Expected after Subarachnoid Hemorrhage (FRESH) score, which they validated in a separate sample of 413 patients enrolled in the CONSCIOUS-1 trial. The percentage of poor outcomes (modified Rankin Scale scores, 4–6) increased with increasing FRESH score from 1 to 9: 3%, 6%, 12%, 38%, 61%, 83%, 92%, 98%, and 100%. The score showed outstanding discrimination in the derivation cohort (area under the curve, 0.90) and moderate discrimination in the external validation cohort (0.77). The score's performance was similar when excluding patients for whom care was withdrawn. In the derivation cohort, the discrimination of the FRESH score (0.90) was better than the HH score alone (0.85). The FRESH score also had significantly better discrimination than the recently developed HAIR score in both the derivation (0.90 vs. 0.88) and validation (0.77 vs. 0.72) cohorts.

Comment

This report addresses an important gap in neurocritical care, providing a better way to distinguish which patients with severe SAH will eventually recover versus which will be permanently disabled. The FRESH score's higher accuracy requires inputting slightly more detailed data, which is justified by the implications of prognosticating for these sick patients. Given these findings, clinicians should move away from using just the HH score to prognosticate about SAH. The authors have created a free application for a FRESH score calculator (https://itunes.apple.com/us/app/fresh-score/id1015675236?mt=8).

SUMMARY AND COMMENT | STROKE
June 28, 2016

A Better Way to Prognosticate Outcomes After Subarachnoid Hemorrhage
Hooman Kamel, MD Reviewing Witsch J et al., Ann Neurol 2016 Apr 30;
The FRESH score provides more-reliable predictions than the Hunt and Hess score alone.

The Hunt & Hess (HH) score is often used to prognosticate about neurological recovery after subarachnoid hemorrhage (SAH), but many patients with high HH scores will nevertheless recover well. To develop a more sophisticated prognostication score, researchers used a prospective registry of more than 1500 SAH patients at a single tertiary-care center between 1996 and 2014 to…

1 vote

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Los Angeles Klassifikation

Endoskopische Einteilung der Refluxoesophagitis

2 votes

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Waterlow Scale

pressure sores

14 votes

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Waist-Hip Ratio

Obesity control.

13 votes

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Baux Score

Severity of burns.

14 votes

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Delta de troponina

4 votes

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Ogino Kanaus

Método de anticoncepción natural, siguiendo el ciclo menstrual

1 vote

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Monumental de Folstein

1 vote

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SCORE

global cardiovascular risk

15 votes

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AKIN (ICU score)

UL

16 votes

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Coronary Pression Perfusion

1 vote

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Proposed Statin Myalgia index score

3 votes

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PISA model (Prognosis In Suspected Angina)

https://www.sealedenvelope.com/trials/pisa/

2 votes

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National Pressure Ulcer Advisory Panel (NPUAP)

Classification of pressure ulcer by NPUAP

1 vote

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Arozullah respiratory failure index

Pre-OP

11 votes

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Bother Score

1 vote

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Berkow formula

To estimate burn size % based on area of burn in isolated body part

1 vote

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Duparc

Fracture extremite superieure humerus

2 votes

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Identifying Patients Harboring Extended-Spectrum- -Lactamase-Producing Enterobacteriaceae on Hospital Admission: Derivation

Identificar pacientes con riesgo de entero bacterias productoras de betalactamasa de espectro extendido.

1 vote

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