Perbandingan Tingkat Akurasi Antara Intraventricular Hemorrhage Score (IVH SCORE / IVHS), Modified Graeb Score (mGS), dan LeRoux Score Untuk Menilai Outcome Stroke Hemoragik

Abstract

Background : Assessment methods for evaluating intraventricular hemorrhage, until now, are not well established. Purpose : For evaluation the predictive diagnostic accuracies of the Intraventricular Hemorrhage Score (IVH Score or IVHS), Modified Graeb Score (mGS), and LeRoux Score in evaluating outcome of the hemorrhagic stroke. Methods : This was a cross sectional study of 49 hemorrhagic stroke patients that must be found intraventricular hemorrhage will be evaluation with using the IVH Score, Modified Graeb Score, and LeRoux Score when they come to Haji Adam Malik Medan General Hospital. Outcome of the hemorrhagic stroke are evaluated with using Modified Rankin Scale (mRS). Poor outcome was defined as mRS scores > 3. Results : Sensitivity of IVH Score 72.1%, Modified Graeb Score 69.8% and LeRoux Score 65.1%. Specificity of IVH Score 66.7%, Modified Graeb Score 50%, and LeRoux Score 50%. AUC values for IVH Score 0.797, Modified Graeb Score 0.703 and LeRoux Score 0.696. The value of diagnostic accuracy for IVH Score 0.71, Modified Graeb Score 0.694 and LeRoux Score 0.592. Positive predictive value for IVH Score 0.25, Modified Graeb Score 0.23 and LeRoux Score 0.15. Negative predictive value for IVH Score 0.94, Modified Graeb Score of 0.93 and LeRoux Score 0.89. Positive Likelihood Ratio for IVH Score 2.1, Modified Graeb Score 1.39 and LeRoux Score 1.302. Negative Likelihood Ratio Score for IVH Score 0.42, Modified Graeb Score 0.604 and LeRoux Score 0.698. Conclusion: Intraventricular Hemorrhage Score looks better accuracy in evaluating or predicting the outcome of hemorrhagic stroke compared with Modified Graeb Score and LeRoux Score (P value < 0.05).

Latar Belakang : Metode penilaian yang mengevaluasi perdarahan intraventrikular belum dikenal dengan baik hingga saat ini. Tujuan : Untuk mengevaluasi prediksi akurasi diagnostik dari Intraventricular Hemorrhage Score (IVH Score / IVHS), Modified Graeb Score (mGS), dan LeRoux Score dalam menilai outcome stroke hemoragik. Metode : Studi potong lintang yang dilakukan terhadap 49 orang pasien stroke hemoragik yang dijumpai perdarahan intraventrikular yang akan dievaluasi dengan menggunakan IVH Score, Modified Graeb Score, dan LeRoux Score pada saat datang ke RSUP Haji Adam Malik Medan. Outcome stroke hemoragik dinilai dengan menggunakan Modified Rankin Scale (mRS). Outcome buruk dinyatakan dengan nilai mRS>3. Hasil : Sensitivitas IVH Score 72,1%, Modified Graeb Score 69,8% dan LeRoux Score 65,1%. Spesifisitas IVH Score 66,7%, Modified Graeb Score 50%, dan LeRoux Score 50%. Nilai AUC untuk IVH Score 0,797, Modified Graeb Score 0,703, dan LeRoux Score 0,696. Nilai akurasi diagnostik IVH Score 0,71, Modified Graeb Score 0,694 dan LeRoux Score 0,592. Nilai Duga Positif IVH Score 0,25, Modified Graeb Score 0,23 dan LeRoux Score 0,15. Nilai Duga Negatif IVH Score 0,94, Modified Graeb Score 0,93 dan LeRoux Score 0,89. Rasio Kemungkinan Positif IVH Score 2,1, Modified Graeb Score 1,39 dan LeRoux Score 1,302. Rasio Kemungkinan Positif IVH Score 0,42, Modified Graeb Score 0,604 dan LeRoux Score 0,698. Kesimpulan : Intraventricular Hemorrhage Score terlihat lebih baik akurasinya dalam menilai atau memprediksi outcome stroke hemoragik dibandingkan dengan Modified Graeb Score dan LeRoux Score (P value < 0,05).