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Short Report
International multicentre validation of the arteriovenous malformation-related intracerebral haemorrhage (AVICH) score
  1. Marian C. Neidert1,
  2. Michael T. Lawton2,
  3. Louis J. Kim3,
  4. John D. Nerva3,
  5. Kaoru Kurisu4,
  6. Fusao Ikawa4,
  7. Juergen Konczalla5,
  8. Nazife Dinc5,
  9. Volker Seifert5,
  10. Julian Habdank-Kolaczkowski2,
  11. Taketo Hatano6,
  12. Makoto Hayase7,
  13. Dino Podlesek8,
  14. Gabriele Schackert8,
  15. Thomas Wanet9,
  16. Sven Gläsker9,
  17. Christoph J. Griessenauer10,
  18. Christopher S. Ogilvy10,
  19. Andreas Kneist11,
  20. Ulrich Sure11,
  21. Burkhardt Seifert12,
  22. Luca Regli1,
  23. Oliver Bozinov1,
  24. Jan-Karl Burkhardt1,2
  1. 1Department of Neurosurgery, University Hospital Zurich, Zurich, Switzerland
  2. 2Department of Neurological Surgery, University of California San Francisco, San Francisco, California, USA
  3. 3Department of Neurosurgery, University of Washington, Seattle, USA
  4. 4Department of Neurosurgery, Graduate School of Biomedical and Health Sciences Hiroshima University, Hiroshima, Japan
  5. 5Department of Neurosurgery, University Hospital Frankfurt, Frankfurt, Germany
  6. 6Department of Neurosurgery, Kokura Memorial Hospital, Fukuoka, Japan
  7. 7Department of Neurosurgery, Fukui Red Cross Hospital, Fukui, Japan
  8. 8Department of Neurosurgery, University Hospital Dresden, Dresden, Germany
  9. 9Department of Neurosurgery, University Hospital VUB Brussels, Belgium
  10. 10Neurosurgical Service, Beth Israel Deaconess Medical Center, Harvard University, Boston, USA
  11. 11Department of Neurosurgery, University Hospital Essen, Essen, Germany
  12. 12Department of Biostatistics, Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland.
  1. Correspondence to Dr. Jan-Karl Burkhardt, Department of Neurological Surgery, University of California San Francisco, San Francisco, CA 94143, USA; jankarl.burkhardt{at}


Objective The recently published arteriovenous malformation-related intracerebral haemorrhage (AVICH) score showed better outcome prediction for patients with arteriovenous malformation (AVM)-related intracerebral haemorrhage (ICH) than other AVM or ICH scores. Here we present the results of a multicentre, external validation of the AVICH score.

Methods All participating centres (n=11) provided anonymous data on 325 patients to form the Spetzler-Martin (SM) grade, the supplemented SM (sSM) grade, the ICH score and the AVICH score. Modified Rankin score (mRS) at last follow-up (mean 25.6 months) was dichotomized into favourable (mRS 0-2, n=210) and unfavourable (mRS 3-6;n=115). Univariate and AUROC analyses were performed to validate the AVICH score.

Results Except nidus structure and AVM size, all single parameters forming the SM, sSM, ICH and AVICH score and the scores itself were significantly different between both outcome groups in the univariate analysis. The AVICH score was confirmed to be the highest predictive outcome score with an AUROC of 0.765 compared with 0.705 for the ICH score and 0.682 for the sSM grade.

Conclusion The multicentre-validated AVICH score predicts clinical outcome superior to pre-existing scores. We suggest the routine use of this score for future clinical outcome prediction and in clinical research.

Trial registration number NCT02920645.

  • cerebrovascular

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  • Contributors MCN, MTL, LR, OB, J-KB: conception, design and analysis and interpretation of data. MCN and J-KB: drafting of manuscript. LJK, JDN, KK, FI, JK, ND, VS, JH-K, TH, MH, DP, GS, TW, SG, CJG, CSO, AK and US: collection, analysis and interpretation of data. BS, MCN and JKB: statistical analysis. All authors: revising manuscript draft and approval of final manuscript version.

  • Ethics approval The study was performed in accordance with the ethical guidelines at each local study center and a waiver from the local ethics committee in Zurich was obtained (BASEC-Nr.Req-2016-00514). The study protocol was published and registered at (NCT02920645).

  • Provenance and peer review Not commissioned; externally peer reviewed.