Estimating the Outcomes of Intracerebral Haemorrhage with Intracerebral Haemorrhage Score and Acute Physiology and Chronic Health Evaluation-II Score: A Multicentre Study

Abstract

Objective: Spontaneous intracerebral haemorrhage causes mortality or leads to permanent disability in most of the survivors. Thus, determining the severity of the disease to predict mortality and morbidity is important. This study aimed to evaluate Acute Physiology and Chronic Health Evaluation-II and Intracerebral Haemorrhage scores in spontaneous intracerebral haemorrhage patients treated in intensive care units. Methods: This multicenter study was conducted in 2 tertiary care hospitals’ general intensive care units. Short- (in-hospital) and long-term (1-year) mortality and functional outcomes at discharge were evaluated using the Intracerebral Haemorrhage and Acute Physiology and Chronic Health Evaluation-II scores. Results: Of the 35 spontaneous intracerebral haemorrhage patients analysed, the modified Ranking Scale was <4 in 10 (28.6%) patients and ≥4 in 25 (71.4%) patients. The in-hospital mortality was 51.4%, and 1-year mortality was 60%. The discriminative power of Acute Physiology and Chronic Health Evaluation-II was excellent (area under the curve ≥0.9), and Intracerebral Haemorrhage Score was fair (area under the curve ≥0.7) for both in-hospital mortality and poor outcomes at discharge. The area under the curve of Acute Physiology and Chronic Health Evaluation-II was significantly higher than the area under the curve of Intracerebral Haemorrhage score. Conclusion: Acute Physiology and Chronic Health Evaluation-II score is a better model with high sensitivity and specificity than the Intracerebral Haemorrhage score in predicting the in-hospital mortality and functional outcomes at the discharge of spontaneous intracerebral haemorrhage patients. However, the Acute Physiology and Chronic Health Evaluation-II score lacks the neuroradiologic features that are crucial for spontaneous intracerebral haemorrhage. Therefore, the Intracerebral Haemorrhage score can be used as an indicator of neurological status combined with the Acute Physiology and Chronic Health Evaluation-II score rather than as a predictive model of outcomes.