Sembill et al reported the Max-ICH score for evaluating a patient with intracerebral hemorrhage. This can help to identify a patient who may benefit from more aggressive management. The authors are from University Hospital Erlangen in Germany.
Patient selection: intracerebral hemorrhage
Outcome: modified Rankin scale
Parameters:
(1) NIHSS
(2) age in years
(3) intraventricular hemorrhage
(4) oral anticoagulation
(5) lobar ICH volume in cubic centimeters (cortex, cortical-subcortical junction)
(6) nonlobar ICH volume in cubic centimeters (deep, cerebellar, brainstem)
Parameter
Finding
Points
NIHSS
0 to 6
0
7 to 13
1
14 to 20
2
>= 21
3
age in years
<= 69 years
0
70 to 74 years
1
75 to 79 years
2
>= 80 years
3
intraventricular hemorrhage
no
0
yes
1
oral anticoagulation
no
0
yes
1
lobar ICH volume
< 30 cc
0
>= 30 cc
1
nonlobar ICH volume
<10 cc
0
>= 10 cc
1
where:
• Scoring for ICH volume is based on the probable site of origin for the hemorrhage. For most patients only 1 point is assigned for lobar and nonlobar ICH volumes (Footnote Table 2).
total score =
= SUM(points for all 6 parameters)
Interpretation:
• minimum score: 0
• maximum score: 10
• The higher the score the worse the 12 month functional outcome.
Performance:
• The area under the ROC curve was 0.81.
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