Predicting 30-day mortality in patients with primary intracerebral hemorrhage (ICH): Evaluation of the value of intracerebral hemorrhage and modified new intracerebral hemorrhage scores
Background: Different criteria have been proposed to determine the mortality rate of primary intracerebral hemorrhage (ICH). This study aimed to evaluate ICH and Modified New ICH scores in predicting 30-day mortality in patients with primary ICH.
Methods: In this prospective cohort study, 107 patients diagnosed with primary ICH were enrolled at an interval of six months (October 2015-March 2016). They were evaluated using Modified New ICH and ICH scores. The Modified New ICH score was different from the New ICH score since the National Institute of Health Stroke Scale (NIHSS) variables were replaced by Modified Rankin Scale (MRS) in the modified score.
Results: A total of 61 patients (57%) died, and
46 (43%) survived during the 30-day hospitalization. ICH ≥ 2 and Modified New ICH ≥ 3 scores predicted 30-day mortality rate in patients with the sensitivity and specificity rates of 87 and 63 percent, and 88 and 53 percent, respectively.
2. Crandall KM, Rost NS, Sheth KN. Prognosis in intracerebral hemorrhage. Rev Neurol Dis 2011; 8(1-2): 23-9.
3. Crozier S. Withdrawing and withholding treatments in acute severe stroke patients: Clinical and ethical issues. Presse Med 2012; 41(5): 525-31.
4. Zahuranec DB, Brown DL, Lisabeth LD, Gonzales NR, Longwell PJ, Smith MA, et al. Early care limitations independently predict mortality after intracerebral hemorrhage. Neurology 2007; 68(20): 1651-7.
5. Hemphill JC 3rd, Bonovich DC, Besmertis L, Manley GT, Johnston SC. The ICH score: A simple, reliable grading scale for intracerebral hemorrhage. Stroke 2001; 32(4): 891-7.
6. Clarke JL, Johnston SC, Farrant M, Bernstein R, Tong D, Hemphill JC 3rd. External validation of the ICH score. Neurocrit Care 2004; 1(1): 53-60.
7. Cheung RT, Zou LY. Use of the original, modified, or new intracerebral hemorrhage score to predict mortality and morbidity after intracerebral hemorrhage. Stroke 2003; 34(7): 1717-22.
8. Banks JL, Marotta CA. Outcomes validity and reliability of the modified Rankin scale: Implications for stroke clinical trials: A literature review and synthesis. Stroke 2007; 38(3): 1091-6.
9. Ebrahimi Bakhtavar H, Morteza Bagi HR, Rahmani F, Shahsavari Nia K, Ettehadi A. Clinical scoring systems in predicting the outcome of acute upper gastrointestinal bleeding; A narrative review. Emerg (Tehran) 2017; 5(1): e36.
10. Rahmani F, Ebrahimi Bakhtavar H, Soleimanpour H, Ala A, Shams Vahdati S, Rikhtegar R. Predicting of mortality in patients with intracranial hemorrhage: A review article. J Anal Res Clin Med 2014; 2(4): 167-70.
11. Safari S, Rahmani F, Soleimanpour H, Ebrahimi Bakhtavar H, Mehdizadeh Esfanjani R. Can APACHE II score predict diabetic ketoacidosis in hyperglycemic patients presenting to emergency department? Anesth Pain Med 2014; 4(4): e21365.
12. Rincon F, Mayer SA. The epidemiology of intracerebral hemorrhage in the United States from 1979 to 2008. Neurocrit Care 2013; 19(1): 95-102.
13. Roger VL, Go AS, Lloyd-Jones DM, Adams RJ, Berry JD, Brown TM, et al. Heart disease and stroke statistics-2011 update: A report from the American Heart Association. Circulation 2011; 123(4): e18-e209.
14. Lisk DR, Pasteur W, Rhoades H, Putnam RD, Grotta JC. Early presentation of hemispheric intracerebral hemorrhage: Prediction of outcome and guidelines for treatment allocation. Neurology 1994; 44(1): 133-9.
15. Juvela S. Risk factors for impaired outcome after spontaneous intracerebral hemorrhage. Arch Neurol 1995; 52(12): 1193-200.
16. Fric-Shamji EC, Shamji MF, Cole J, Benoit BG. Modifiable risk factors for intracerebral hemorrhage: Study of anticoagulated patients. Can Fam Physician 2008; 54(8): 1138-9, 139.
17. Caceres JA, Goldstein JN. Intracranial hemorrhage. Emerg Med Clin North Am 2012; 30(3): 771-94.
18. Crocco TJ, Goldstein JN. Stroke. In: Marx JA, Hockberger RS, Walls RM, Editors. Rosen's emergency medicine: Concepts and clinical practice. Philadelphia, PA: Elsevier/Saunders; 2014. p. 1363-74.
19. Narayan SK, Sivaprasad P, Sushma S, Sahoo RK, Dutta TK. Etiology and outcome determinants of intracerebral hemorrhage in a south Indian population, A hospital-based study. Ann Indian Acad Neurol 2012; 15(4): 263-6.
20. Meyer DM, Begtrup K, Grotta JC. Is the ICH score a valid predictor of mortality in intracerebral hemorrhage? J Am Assoc Nurse Pract 2015; 27(7): 351-5.
21. Safatli DA, Gunther A, Schlattmann P, Schwarz F, Kalff R, Ewald C. Predictors of 30-day mortality in patients with spontaneous primary intracerebral hemorrhage. Surg Neurol Int 2016; 7(Suppl 18): S510-S517.
22. Hemphill JC 3rd, Farrant M, Neill TA Jr. Prospective validation of the ICH Score for 12-month functional outcome. Neurology 2009; 73(14): 1088-94.
23. Cho DY, Chen CC, Lee WY, Lee HC, Ho LH. A new modified intracerebral hemorrhage score for treatment decisions in basal ganglia hemorrhage--a randomized trial. Crit Care Med 2008; 36(7): 2151-6.
24. Fernandes H, Gregson BA, Siddique MS, Mendelow AD. Testing the ICH score. Stroke 2002; 33(6): 1455-6.