• Raymond Tak Fai Cheung and Liang-Yu Zou.
• Division of Neurology, University Department of Medicine, Queen Mary Hospital, Pokfulam, Hong Kong. rtcheung@hkucc.hku.hk
• Stroke. 2003 Jul 1;34(7):1717-22.

Background And PurposeA simple clinical scale of intracerebral hemorrhage (ICH), comprising the Glasgow Coma Scale score, age, infratentorial origin, ICH volume, and intraventricular hemorrhage, was recently shown to predict 30-day mortality. We studied how well the original ICH Score would predict morbidity and mortality and determined whether modification would improve the predictions.MethodsPatients admitted to a regional hospital with acute ICH in 1999 were reviewed. Independent predictors of mortality or good outcome (modified Rankin score ResultsThe mortality rate was 22%, and 35% had good outcome. Independent factors for mortality were high NIHSS score, intraventricular hemorrhage, subarachnoid extension, and narrow pulse pressure. Independent factors for good outcome were low NIHSS score and low admission temperature. For all ICH Scores, no patient had a maximum score of 6. Cutoff values of >or=3 and <3 provided the best Youden's index of diagnostic test in all ICH Scores for mortality and good outcome, respectively. The original and modified ICH Scores predict mortality equally well. The new and modified ICH Scores are slightly better for prediction of good outcome.ConclusionsAll 3 ICH Scores are simple clinical grading scales. As reliable predictors of good outcome and/or mortality, they are useful in clinical research studies and standardization of clinical protocols.

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