Predictors of poor outcome at hospital discharge following a spontaneous intracerebral hemorrhage.
BACKGROUND
Spontaneous intracranial hemorrhage (S-ICH) often leads to significant morbidity and mortality. Clinical scoring systems can predict the mortality and functional outcome after ICH (FUNC score). FOUR score is a recently developed coma scale that incorporates brainstem reflexes. We propose that the combination of FUNC and FOUR scores will be a better prognostic indicator than either FUNC or FOUR score alone for S-ICH patients.


METHODS
We conducted a retrospective chart review of all S-ICH patients (>18 years of age) from January 2008 to May 2010. ICH volume was calculated using the ABC/2 formula. FUNC (≤ 5 or >5) and FOUR (≤ 10 and >10) scores were calculated from admission data. Statistical analyses included chi-square test, positive predictive value, and relative risk assessment.


RESULTS
Total number of patients was 92. The mean age of presentation was 64.6 ± 15.6 years (range: 27-95 years). Male to female ratio was 1.6:1. Combined FUNC score ≤ 5 and FOUR score ≤ 10 (F2 score; 95%) had higher positive predictive value for mortality than either FUNC score ≤ 5 (82%) or FOUR score ≤ 10 (81%).


CONCLUSIONS
The combination of the FUNC and the FOUR scoring system is a better prognostication indicator for S-ICH patients than either FUNC or FOUR score.
Department of Neurology, University of Kansas Medical Center, Kansas City, Kansas 66160, USA. mmittal2@kumc.edu
Manoj Kumar
MK
Mittal
Abhijit
A
Lele
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002543:Cerebral Hemorrhage / Q000175:diagnosis* / Q000401:mortality*; D015331:Cohort Studies; D004185:Disability Evaluation; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care / Q000379:methods*; D010351:Patient Discharge; D011237:Predictive Value of Tests; D011379:Prognosis; D012189:Retrospective Studies; D018570:Risk Assessment