Cheung and Zou developed a new ICH Score based on the one 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) temperature in °C
(3) pulse pressure in mm Hg
(4) intraventricular hemorrhage
(5) subarachnoid extension of the bleeding
where:
• Pulse pressure = (systolic blood pressure) - (diastolic blood pressure).
|
Parameter |
Finding |
Points |
|
NIHSS |
0 to 10 |
0 |
|
|
11 to 20 |
1 |
|
|
21 to 40 |
2 |
|
temperature in °C |
<= 36°C |
0 |
|
|
> 36°C |
1 |
|
pulse pressure |
>= 60 mm Hg |
0 |
|
|
< 60 mm Hg |
1 |
|
intraventricular hemorrhage |
absent |
0 |
|
|
present |
1 |
|
subarachnoid extension |
absent |
0 |
|
|
present |
1 |
new 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.
|
Modified ICH Score |
Good Outcome |
30 Day Mortality Rate |
|
0 |
100% |
0% |
|
1 |
84% |
0% |
|
2 |
36% |
8% |
|
3 |
18% |
33% |
|
4 |
0% |
58% |
|
5 or 6 |
0% |
100% |
from page 1720
Performance:
• The sensitivity for a good outcome was 70% and specificity was 92%, with a Youden index of 62%.
• The sensitivity for 30 day mortality was 91% and specificity was 73%, with a Youden index of 64%.
Specialty: Neurology
ICD-10: ,
