{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,9]],"date-time":"2026-07-09T06:16:45Z","timestamp":1783577805879,"version":"3.55.0"},"reference-count":30,"publisher":"Oxford University Press (OUP)","issue":"1","license":[{"start":{"date-parts":[[2026,1,2]],"date-time":"2026-01-02T00:00:00Z","timestamp":1767312000000},"content-version":"vor","delay-in-days":1,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,1,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Predicting the occurrence of late seizures after intracerebral haemorrhage may help in making clinical decisions about treatment. Currently, the CAVE score is the best performing risk score. We aimed to design a different, pragmatic risk prediction score and compared it to the CAVE score.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Patients and methods<\/jats:title>\n                    <jats:p>The South Limburg (Netherlands) intracerebral haemorrhage registry, consisting of patients with a primary intracerebral haemorrhage in 2004\u20132009, was used for the derivation cohort. We made a prediction model using Cox proportional hazard analyses; comparisons between models were made with the c-statistic. We validated our model externally in three independent cohorts.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Our derivation cohort consisted of 781 patients, of whom 78 (10%) developed late seizures. We found the following independent predictors for late seizures: any neurosurgical procedure, age\u2009&amp;lt;\u200965\u2009years, lobar haemorrhage, and early seizures (occurring within the first week). These formed our new prediction score (LEAN score), which had an optimism-corrected c-statistic of 0.80 (95%-confidence interval 0.78\u20130.86). The LEAN score predicts late seizure risk as 0.7%, 1.6%, 8.8%, 22.0%, 29.8%, 43.5%, 100% for the increasing score groups respectively. External validation showed comparable optimism-corrected c-statistics for both the LEAN score and the CAVE score.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The newly developed LEAN score consists of easily available clinical variables and performs equally to the CAVE score. Additionally, the high risk of late seizures in patients with the maximum LEAN score might make a diagnosis of epilepsy possible according to international guidelines despite these patients only had early seizures.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/esj\/23969873251350882","type":"journal-article","created":{"date-parts":[[2026,1,20]],"date-time":"2026-01-20T11:01:30Z","timestamp":1768906890000},"source":"Crossref","is-referenced-by-count":2,"title":["Development and external validation of the LEAN score to predict late seizures after intracerebral haemorrhage"],"prefix":"10.1093","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0009-0004-8406-2715","authenticated-orcid":false,"given":"Frederik J","family":"Reitsma","sequence":"first","affiliation":[{"name":"Department of Neurology , Maastricht University Medical Center+, Maastricht ,","place":["Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sander M J","family":"van Kuijk","sequence":"additional","affiliation":[{"name":"Department of Clinical Epidemiology and Medical Technology Assessment (KEMTA) , Maastricht University Medical Center+, Maastricht ,","place":["Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David J","family":"Werring","sequence":"additional","affiliation":[{"name":"UCL Stroke Research Centre , Department of Brain Repair and Rehabilitation, UCL Queen Square Institute of Neurology and the National Hospital for Neurology and Neurosurgery, London ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0190-7782","authenticated-orcid":false,"given":"Gargi","family":"Banerjee","sequence":"additional","affiliation":[{"name":"UCL Stroke Research Centre , Department of Brain Repair and Rehabilitation, UCL Queen Square Institute of Neurology and the National Hospital for Neurology and Neurosurgery, London ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charlotte","family":"Cordonnier","sequence":"additional","affiliation":[{"name":"Univ. Lille , Inserm, CHU Lille, U1172 - LilNCog - Lille Neuroscience & Cognition, Lille ,","place":["France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Olfa","family":"Kaaouana","sequence":"additional","affiliation":[{"name":"Univ. Lille , Inserm, CHU Lille, U1172 - LilNCog - Lille Neuroscience & Cognition, Lille ,","place":["France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laurent","family":"Puy","sequence":"additional","affiliation":[{"name":"Univ. Lille , Inserm, CHU Lille, U1172 - LilNCog - Lille Neuroscience & Cognition, Lille ,","place":["France"]},{"name":"Division of Behavioral Neurology , Department of Neurology, Massachusetts General Hospital, Boston, MA ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anand","family":"Viswanathan","sequence":"additional","affiliation":[{"name":"Division of Behavioral Neurology , Department of Neurology, Massachusetts General Hospital, Boston, MA ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert J","family":"van Oostenbrugge","sequence":"additional","affiliation":[{"name":"Department of Neurology , Maastricht University Medical Center+, Maastricht ,","place":["Netherlands"]},{"name":"School for Mental Health and Neurosciences , Maastricht University, Maastricht ,","place":["Netherlands"]},{"name":"School for cardiovascular diseases (CARIM) , Maastricht University, Maastricht ,","place":["Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9502-6937","authenticated-orcid":false,"given":"Julie","family":"Staals","sequence":"additional","affiliation":[{"name":"Department of Neurology , Maastricht University Medical Center+, Maastricht ,","place":["Netherlands"]},{"name":"School for Mental Health and Neurosciences , Maastricht University, Maastricht ,","place":["Netherlands"]},{"name":"School for cardiovascular diseases (CARIM) , Maastricht University, Maastricht ,","place":["Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rob P W","family":"Rouhl","sequence":"additional","affiliation":[{"name":"Department of Neurology , Maastricht University Medical Center+, Maastricht ,","place":["Netherlands"]},{"name":"School for Mental Health and Neurosciences , Maastricht University, Maastricht ,","place":["Netherlands"]},{"name":"Academic Center for Epileptology Kempenhaeghe , 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