Development and validation of a prognostic model to predict recovery following intracerebral hemorrhage.
BACKGROUND
While several models have been developed to predict mortality following intracerebral hemorrhage (ICH), the functional outcome and its predictors in surviving patients have been poorly investigated so far.


OBJECTIVE
To identify predictors and validate a prognostic model for independent functional outcome in patients with acute ICH.


METHODS
An inception cohort was assessed on the National Institutes of Health Stroke Scale (NIH-SS) at admission and followed-up after 100 days.


METHODS
11 neurological departments with an acute stroke unit.


METHODS
207 consecutive patients who were neither comatose nor intubated at admission within 6 hours after ICH and with complete follow-up.


RESULTS
After 100 days, 40 patients (19.3 %) had died, 78 (37.7%) had regained functional independence (Barthel Index > or = 95) and 89 (43%) had survived but not recovered. In these patients, age and the NIH-SS total score were identified as independent predictors for functional independence after 100 days. With the predefined cut-off value, the prognosis of 79.8% of all patients could be predicted accurately upon validation in an independent data set of 173 non-comatose patients with acute ICH.


CONCLUSIONS
Our study provides a validated prognostic model for prediction of complete recovery following ICH which could be very useful for the design of clinical studies.
Weimar
Christian
C
Department of Neurology, University of Duisburg-Essen, Hufelandstrasse 55, 45122 Essen, Germany. stroke.med@uni-essen.de
Roth
Michael
M
Willig
Vera
V
Kostopoulos
Panagiotis
P
Benemann
Jens
J
Diener
Hans-Christoph
HC
D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D002543:Cerebral Hemorrhage / Q000175:diagnosis* / Q000401:mortality / Q000503:physiopathology*; D005260:Female; D006801:Humans; D008297:Male; D008954:Models, Biological; D009460:Neurologic Examination / Q000706:statistics & numerical data*; D011237:Predictive Value of Tests; D011379:Prognosis; D020127:Recovery of Function / Q000502:physiology*; D012044:Regression Analysis; D015203:Reproducibility of Results; D012189:Retrospective Studies; D016019:Survival Analysis