Related Experiment Video
Updated: Feb 26, 2026
07:12
Real-Time Monitoring of Neurocritical Patients with Diffuse Optical Spectroscopies
Published on: November 19, 2020
2.6K
A multiparameter model predicting in-hospital mortality in malignant cerebral infarction
Chien-Fu Chen1, Ruey-Tay Lin, Hsiu-Fen Lin
1Department of Neurology, Kaohsiung Medical University Hospital Department of Neurology, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.
Medicine
|July 13, 2017
Summary
Early identification of large hemisphere infarctions (LHIs) using admission parameters can predict mortality. A quantitative model incorporating complete MCA infarction and CHADS2 scores identifies high-risk patients for better therapeutic strategies.
Area of Science:
- Neurology
- Stroke Medicine
- Critical Care
Background:
- Large hemisphere infarctions (LHIs) carry a high risk of fatal brain edema.
- Early identification of at-risk patients is crucial for improved outcomes.
- Predictive models at admission may aid in stratifying mortality risk.
Purpose of the Study:
- To develop and validate a quantitative model for predicting in-hospital mortality in patients with LHIs.
- To identify early clinical and radiographic predictors of mortality in LHI patients.
- To assess the utility of the CHADS2 score in predicting LHI outcomes.
Main Methods:
- Prospective study of 77 patients with LHIs (>50% MCA territory) within 48 hours of symptom onset.
- Analysis of early clinical, radiographic parameters, and baseline CHADS2 score.
- Development of two mortality scores based on complete MCA infarction (CMCA), CHADS2, and NIHSS scores.
Main Results:
- Complete MCA infarction (CMCA) predictors included hypodensity, hyperdense MCA sign, edema, NIHSS ≥17, and stroke progression.
- Mortality score 1 (CMCA + CHADS2 ≥4) showed 100% sensitivity and 57.4% specificity.
- Mortality score 2 (CMCA + CHADS2 ≥4 + NIHSS ≥26 within 5 days) showed 100% sensitivity and 91.7% specificity.
Conclusions:
- A quantitative model incorporating CMCA, CHADS2, and NIHSS scores effectively predicts in-hospital mortality in LHI patients.
- Patients with a mortality score of 2 are at high risk and may benefit from aggressive therapeutic interventions.
- These findings can guide clinical decision-making and resource allocation for LHI management.