ADAM ‐C score: New risk score for predicting diagnostic yield of transesophageal echocardiography after cerebral ischemia - Université de La Réunion Access content directly
Journal Articles Echocardiography Year : 2018

ADAM ‐C score: New risk score for predicting diagnostic yield of transesophageal echocardiography after cerebral ischemia

Christophe Jego
  • Function : Author
Ulric Vinsonneau
  • Function : Author
Philippe Garçon
  • Function : Author
Guillaume Turlotte
  • Function : Author
Jean François Rivière
  • Function : Author
Marion Maurin
  • Function : Author
Rémy Lubret
  • Function : Author
Patrick Meimoun
  • Function : Author
Chrystelle Akret
  • Function : Author
Charles Sokic
  • Function : Author
Laurent Michel
  • Function : Author
Maryse Lescure
  • Function : Author
Marie Melay
  • Function : Author
Maxime Fayard
  • Function : Author
Bruno Gallet
  • Function : Author
Rémi Fouche
  • Function : Author
Luc Janin-Manificat
  • Function : Author
Nicolas Dijoux
  • Function : Author
Anne Céline Martin
  • Function : Author
Aurélia Tho-Agostini
  • Function : Author
Hubert Mann
  • Function : Author
Cécile Ricard
  • Function : Author
Fernando Pico
  • Function : Author
Jean Louis Georges
  • Function : Author
Loïc Belle
  • Function : Author
Patrick Jourdain
  • Function : Author

Abstract

Background and aim The clinical utility of transesophageal echocardiography ( TEE ) after brain ischemia ( BI ) remains a matter of debate. We aimed to evaluate the clinical impact of TEE and to build a score that could help physicians to identify which patients should better benefit from TEE . Methods This prospective, multicenter, observational study included patients over 18 years old, hospitalized for BI . TEE findings were judged discriminant if the results showed important information leading to major changes in the management of patients. Most patients with patent foramen ovale were excluded. Variables independently associated with a discriminant TEE were used to build the prediction model. Results Of the entire population (1479 patients), 255 patients (17%) were classified in the discriminant TEE group. Five parameters were selected as predictors of a discriminant TEE . Accordingly, the ADAM ‐C score could be calculated as follows: Score = 4 (if age ≥60) + 2 (if diabetes) + 2 (if aortic stenosis from any degrees) + 1 (if multi‐territory stroke) + 2 (if history of coronary artery disease). At a threshold lower than 3, the sensitivity, specificity, positive predictive value, and negative predictive value ( NPV ) of detecting discriminant TEE were 88% (95% CI 85–90), 44% (95% CI 41–47), 21% (95% CI 19–27), and 95% (95% CI 94–97), respectively. Conclusion A simple score based on clinical and transthoracic echocardiographic parameters can help physicians to identify patients who might not benefit from TEE . Indeed, a score lower than 3 has an interesting NPV of 95% (95% CI 94–97).
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Dates and versions

hal-04542054 , version 1 (11-04-2024)

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Clément Charbonnel, Christophe Jego, François Jourda, Ulric Vinsonneau, Philippe Garçon, et al.. ADAM ‐C score: New risk score for predicting diagnostic yield of transesophageal echocardiography after cerebral ischemia. Echocardiography, 2018, 35 (8), pp.1171-1182. ⟨10.1111/echo.14010⟩. ⟨hal-04542054⟩
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