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R2eD AVM Score.

James Feghali1, Wuyang Yang1, Risheng Xu1

  • 1From the Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, MD.

Stroke
|June 7, 2019
PubMed
Summary
This summary is machine-generated.

This study developed a predictive tool to assess the risk of brain arteriovenous malformation (AVM) hemorrhage. The R2eD AVM scoring system identifies key risk factors to aid clinical judgment and patient counseling.

Keywords:
arteriovenous malformationshemorrhageodds ratioradiosurgeryrisk factors

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Area of Science:

  • Neurology
  • Neurosurgery
  • Radiology

Background:

  • Management of unruptured brain arteriovenous malformations (AVMs) lacks clear guidelines.
  • Hemorrhagic presentation is a significant concern for AVM patients.
  • Risk stratification is crucial for guiding treatment decisions.

Purpose of the Study:

  • To identify risk factors predictive of hemorrhagic presentation in brain AVMs.
  • To develop a predictive tool for hemorrhage risk stratification.
  • To aid in clinical decision-making and patient counseling regarding AVMs.

Main Methods:

  • Utilized a retrospective cohort of 789 AVM patients (1990-2017).
  • Employed a hold-out validation method, splitting data into training and validation sets.
  • Developed a multivariable logistic regression model and a scoring system (R2eD AVM).

Main Results:

  • Identified key risk factors: nonwhite race, small nidus size, deep location, single arterial feeder, and exclusive deep venous drainage.
  • Achieved an area under the curve (AUC) of 0.702 (training) and 0.685 (complete data).
  • Predicted hemorrhage probability ranged from 16% (score 0) to 78% (score 6).

Conclusions:

  • The R2eD AVM model effectively predicts hemorrhage risk in brain AVM patients.
  • This tool can supplement clinical judgment for better patient management.
  • Aids in counseling patients by providing a quantifiable risk score.