Cheung and Zou modified the original ICH Score of Hemphill et al for the evaluation of patients with stroke complicated by hemorrhagic stroke. This can be used to predict both 30 day mortality but also the chances of a good outcome. The authors are from the University of Hong Kong.
A good outcome was defined as a modified Rankin score of 0 to 2 (with a score of 6 indicating death).
Parameters on admission:
(1) NIH stroke score (NIHSS)
(2) age of the patient
(3) origin of hemorrhage
(4) volume of hemorrhage on imaging studies
(5) intraventricular hemorrhage
|
Parameter |
Finding |
Points |
|
NIHSS |
0 to 10 |
0 |
|
|
11 to 20 |
1 |
|
|
21 to 40 |
2 |
|
age of the patient |
< 80 years of age |
0 |
|
|
>= 80 years of age |
1 |
|
origin of hemorrhage |
infratentorial |
0 |
|
|
supratentorial |
1 |
|
volume of hemorrhage |
< 30 mL |
0 |
|
|
>= 30 mL |
1 |
|
intraventricular hemorrhage |
absent |
0 |
|
|
present |
1 |
ICH score =
= SUM(points for all 5 parameters)
Interpretation:
• minimum score: 0
• maximum score: 6
• The higher the score, the worse the 30 day mortality.
• The maximum score seen in the original study was 5, since it is difficult to have an infratentorial hemorrhage with a volume >= 30 mL.
|
Modified ICH Score |
Good Outcome |
30 Day Mortality Rate |
|
0 |
90% |
0% |
|
1 |
52% |
4% |
|
2 |
30% |
6% |
|
3 |
10% |
30% |
|
4 |
0% |
65% |
|
5 or 6 |
0% |
100% |
from page 1720
Performance:
• The sensitivity for a good outcome was 86% and specificity was 78%, with a Youden index of 64%.
• The sensitivity for 30 day mortality was 92% and specificity was 79%, with a Youden index of 71%.
Specialty: Neurology
ICD-10: ,
