Sze-Voon, Yee
(2018)
Review of CHESS score in SAH patients in local Malaysian population.
Masters thesis, Universiti Sains Malaysia.
Abstract
Background and Objective
Chronic hydrocephalus caused by subarachnoid hemorrhage is a reversible and treatable
condition. To date, existing clinical scores for predicting the development of posthemorrhagic
hydrocephalus are few and difficult to apply in the clinical settings. Chronic
Hydrocephalus Ensuing Subarachnoid Hemorrhage Score (CHESS) was first published
in 2015. Although it showed promising results, no external validation has been done
outside Europe. We designed this study to validate the accuracy and reliability of CHESS
score and to also look for other factors that may cause post-hemorrhagic shunt dependent
hydrocephalus.
Methods
A total of 130 patients with acute subarachnoid haemorrhage from 2 tertiary neurosurgery
centres in Malaysia were analysed using the parameters in CHESS score. The CHESS
score was applied retrospectively and the results were compared with the patients’ clinical
data of development of shunt-dependent hydrocephalus. Results were analysed using
binary logistic regression analysis and Goodness-of-Fit test to determine the predictive
value and its distribution with the original data.
Results
Thirty one percent of the studied population developed shunt-dependent hydrocephalus
(n=41). CHESS score showed a OR of 2.184 with p value of 0.000 and 2 other risk factors
were found to be strongly related to development of shunt-dependent hydrocephalus i.e.
early infarct in CT brain (OR 0.182 ; p value 0.004) and Fisher grade >3 (OR 1.986; p
value of 0.047). However, the population distribution of CHESS score is not consistent
with the data of the original author.
Conclusion
CHESS score is a reliable tool in early prediction of shunt-dependent hydrocephalus post
subarachnoid haemorrhage in Malaysia.
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