Is the ICH score a valid predictor of mortality in intracerebral hemorrhage?

Abstract

Purpose The intracerebral hemorrhage (ICH) score utilizes a 0‐ to 6‐point scoring system to predict 30‐day mortality in ICH patients. The purpose of this analysis was to (a) validate the ICH score in an international, heterogeneous population of ICH patients; and (b) assess the usefulness of a 72‐h ICH score. Data sources Analyses were based on data from 399 patients in the Novo Nordisk trial F7ICH‐1371. The ICH score's ability to predict mortality was determined by calculating the sensitivity, specificity, and positive predictive value (PPV). Conclusions Both the baseline and 72‐h ICH score had high specificity but low sensitivity resulting in an overall PPV of 57%–76%. Specificity of the ICH score was higher in the baseline ICH score (95%) as compared to the 72‐h score (89%). Sensitivity of the ICH score was higher in the 72‐h ICH score (75%) as compared to the baseline score (36%). Implications for practice The baseline ICH score provides reasonable PPV while the 72‐h score provides higher sensitivity. ICH scores obtained at baseline and/or 72 h are valid and may help practitioners to more accurately predict 30‐day mortality in ICH patients.

Blood Glutamate Levels Are Closely Related to Acute Lung Injury and Prognosis after Stroke

“…As the clinical manifestations of ALI lack specificity and are often overshadowed by primary disease, and because ALI typically develops rapidly ( 32 ), there is an urgent need to identify an objective and easily measurable parameter that can predict the occurrence of ALI. Several scores at admission have been commonly used to evaluate the severity and predict prognosis after brain injury ( 33 – 35 ); however, we found that blood glutamate levels were more accurate and reliable for predicting the occurrence of ALI and were closely related to the long-term prognosis. In addition, we found blood glutamate levels were always much higher in patients with ALI than in patients without ALI; in patients with ALI, blood glutamate levels gradually decreased over the length of the hospital stay, whereas few changes in blood glutamate levels were observed in patients without ALI (Figure S2B in Supplementary Material).…”

Correct Outcome Prognostication via Sonographic Volumetry in Supratentorial Intracerebral Hemorrhage

“…We were not able to show a difference in ICH-volumes regarding in house-mortality. Others, however, were able to demonstrate that the ICH-score can be used to predict a 30 day-mortality (2, 8).…”

Modifying the intracerebral hemorrhage score to suit the needs of the developing world

“…in 2001 is one of the most widely used scoring systems which has been validated by multiple external studies. [ 11 12 13 14 15 16 17 18 ] The ICH score, however, fails to account for prebleed cognitive impairment. Few other drawbacks of the ICH score are its poor ability to predict functional outcome and failure to incorporate the NIHSS score which is a better predictor of outcome than GCS.…”