Table of Contents
ISRN Stroke
Volume 2013, Article ID 605286, 4 pages
Research Article

24-Hour ICH Score Is a Better Predictor of Outcome than Admission ICH Score

1Stroke Program, Department of Neurology, Tulane University Hospital, 1440 Canal Street, TB-52, Suite 1000, New Orleans, LA 70112-2715, USA
2Neurovascular Service and Neurocritical Care, Department of Neurology, University of California, San Francisco, CA 94143, USA
3Health Services and Outcomes Research Center for Outcome and Effectiveness Research and Education (COERE), University of Alabama at Birmingham, Birmingham, AL 35249, USA
4Center of Excellence in Comparative Effectiveness Research for Eliminating Disparities (CERED), Minority Health & Health Disparities Research Center (MHRC), University of Alabama at Birmingham, Birmingham, AL 35249, USA
5School of Public Health, Department of Epidemiology, University of Alabama at Birmingham, Birmingham, AL 35249, USA
6Division of Neurosciences Critical Care, Department of Anesthesia Critical Care Medicine, Johns Hopkins University, Baltimore, MD 21287, USA
7School of Medicine, Department of Neurology, University of Alabama at Birmingham, Birmingham, AL 35249, USA
8Department of Biostatistics, School of Public Health, University of Alabama at Birmingham, Birmingham, AL 35294, USA

Received 19 August 2013; Accepted 8 September 2013

Academic Editors: D. Dowlatshahi, A. Ducruet, and P. A. Nyquist

Copyright © 2013 Aimee M. Aysenne et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Background. The ICH score is a validated tool for predicting 30-day morbidity and mortality in patients with intracerebral hemorrhage. Aims and/or Hypothesis. The aim of this study is to determine if the ICH score calculated 24 hours after admission is a better predictor of mortality than the ICH score calculated on admission. Methods. Patients presenting to our center with ICH from 7/08–12/10 were retrospectively identified from our prospective stroke registry. ICH scores were calculated based on initial Glasgow coma scale (GCS) and emergent head computed tomography (CT) on initial presentation and were recalculated after 24 hours. Results. A total of 91 patients out of 121 had complete data for admission and 24-hour ICH score. The ICH score changed in 38% from baseline to 24 hours. After adjusting for age, NIHSS on admission, and glucose, ICH score at 24 hours was a significant, independent predictor of mortality (OR = 2.71, 95% CI 1–19–6.20, and ), but ICH score on admission was not (OR = 2.14, 95% CI 0.88–5.24, and ). Conclusion. Early determination of the ICH score may incorrectly estimate the severity and expected outcome after ICH. Calculations of the ICH score 24 hours after admission will better predict early outcomes.