Iranian Journal of Neurology 2018. 17(1):.

Predicting 30-day mortality in patients with primary intracerebral hemorrhage: Evaluation of the value of ICH and modified New ICH Score
Farzad Rahmani, Reza Rikhtegar, Alireza Ala, Aysan Fakhad Rasooli, Haniyeh Ebrahimi Bakhtavar

Abstract


Introduction: Different criteria have been proposed for determining the primary intracerebral hemorrhage (ICH) mortality rate. The aim of the present study was to evaluate ICH Score and modified New ICH Score in predicting 30-day mortality in patients with primary ICH.

Materials and Methods: In this prospective cohort study, a total of 107 patients diagnosed with primary ICH were enrolled into the study at an interval of six months (October 2015-March 2016). The Modified new ICH score and ICH score were evaluated. The Modified new ICH was different from the New ICH score since the NIHSS variable was replaced by Modified Rankin Scale (MRS) in the modified score.

Results: A total of 61 patients (57%) died, and 46 patients (43%) survived during the 30 day of hospitalization. ICH≥2 score and Modified  new ICH≥3 score predicted 30-day mortality rate of patients respectively with sensitivity and specificity of 87%, 63% and 88%, 53%.

Conclusion: The current study showed that both ICH score and Modified new ICH score criteria were almost equally effective in determining the mortality of patients with primary ICH, and both criteria have acceptable value in determining the mortality of patients. Therefore, routine assessment ICH score, and Modified new ICH score in patients with ICH in emergency wards is recommend.


Keywords


Intracranial Hemorrhages, Mortality, Prognosis, Emergency Departments

References


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.

Dennis MS. Outcome after brain haemorrhage. Cerebrovasc Dis. 2003;16(suppl 1):9-13.

Hackman JL, Nelson AM, Ma OJ. Spontaneous Subarachnoid and Intracerebral Hemorrhage. In: Tintinalli JE, editor. Tintinalli's Emergency Medicine: A Comprehensive Study Guide. 8 ed. china: The McGraw-Hill Companies; 2016. p. 1137-41.

Crandall KM, Rost NS, Sheth KN. Prognosis in intracerebral hemorrhage. Reviews in neurological diseases. 2011;8(1-2):23-9.

Crozier S. Withdrawing and withholding treatments in acute severe stroke patients: clinical and ethical issues. National Institues of Health. 2012;41(5):525-31.

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.

Hemphill JC, 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.

Clarke JL, Johnston SC, Farrant M, Bernstein R, Tong D, Hemphill JC. External validation of the ICH score. Neurocritical Care. 2004;1(1):53-60.

Cheung RTF, 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.

Broderick JP, Brott TG, Duldner JE, Tomsick T, Huster G. Volume of intracerebral hemorrhage. A powerful and easy-to-use predictor of 30-day mortality. Stroke. 1993;24(7):987-93.

Banks JL, Marotta CL. Outcomes Validity and Reliability of the Modified Rankin Scale: Implications for Stroke Clinical Trials. Stroke. 2007;38:1091-6.

Ebrahimi Bakhtavar H, Morteza Bagi HM, Rahmani F, Shahsavari nia K, Ettehadi A. Clinical Scoring Systems in Predicting the Outcome of

Acute Upper Gastrointestinal Bleeding; a Narrative Review. Emergency. 2017:In press.

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? Anesthesiology and Pain Medicine. 2014;4(4):e21365.

Rincon F, Mayer SA. The epidemiology of intracerebral hemorrhage in the United States from 1979 to 2008. Neurocritical care. 2013;19(1):95-102.

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.

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.

Juvela S. Risk factors for impaired outcome after spontaneous intracerebral hemorrhage. Archives of neurology. 1995;52(12):1193-200.

Caceres JA, Goldstein JN. Intracranial Hemorrhage. Emergency medicine clinics of North America. 2012;30(3):771-94.

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. Annals of Indian Academy of Neurology. 2012;15(4):263-6.

Fric-Shamji EC, Shamji MF, Cole J, Benoit BG. Modifiable risk factors for intracerebral hemorrhage: Study of anticoagulated patients. Canadian Family Physician. 2008;54(8):1138-9.e4.

Crocco TJ, Goldstein JN. Stroke. In: Marx JA, editor. Rosen's Emergency Medicine. 8 ed. Saunders: Elsevier Inc; 2014. p. 1363-74.

Meyer DM, Begtrup K, Grotta JC. Is the ICH score a valid predictor of mortality in intracerebral hemorrhage? Journal of The American Association of Nurse Practitioners. 2015;27(7):351-5.

Safatli DA, Günther A, Schlattmann P, Schwarz F, Kalff R, Ewald C. Predictors of 30-day mortality in patients with spontaneous primary intracerebral hemorrhage. Surgical Neurology International. 2016;7(suppl 18):s510-s7.

Hemphill JC, Farrant M, Neill TA. Prospective validation of the ICH Score for 12-month functional outcome. Neurology. 2009;73(14):1088-94.

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. Critical care medicine. 2008;36(7):2151-6.

Fernandes H, Gregson BA, Siddique MS, Mendelow AD. Testing the ICH score. Stroke. 2002;33(6):1455-14556.


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