Risk Factors of Ivascu et al for Mortality in an Elderly Patient with Traumatic Intracranial Hemorrhage and a History of Aspirin or Clopidogrel Therapy

 

NOTE: The original article mentions risk factors but does not report a risk score. The following is one way to make the information operational.

 

Patient selection: elderly patient with intracranial hemorrhage after head injury AND a history of antiplatelet agent therapy (aspirin or clopidogrel)

 

Parameters:

(1) initial Glasgow Coma Score (GCS)

(2) grade of intracranial hemorrhage seen on the CT scan (see previous section)

(3) progression of hemorrhage on followup CT scan

Parameter	Finding	Points
initial GCS	>= 13	0
	<= 12	1
grade of intracranial hemorrhage	Grade 1	0
	Grade 2	1
	Grade 3 or 4	2
progression on followup CT scan	absent	0
	present	1

 

where:

• The mean GCS for nonsurvivors was 11.3 +/- 4.9 and for survivors was 14.2 +/- 1.9.

• 7% of patients with Grade 1 hemorrhage died vs 24% of Grade 2 and 50% of Grade 3 or 4.

• It is interesting that only 50% of patients classified as Grade 4 (massive with moribund patient) died.

 

total score =

= SUM(points for all 3 parameters)

 

Interpretation:

• minimum score: 0

• maximum score: 4

• The higher the score the greater the risk of mortality.