title: Validation of clinical prediction scores in patients with primary intracerebral hemorrhage.
abstract: BACKGROUND
  Initial reports of the FUNC score suggest that it may accurately identify those patients suffering from intracerebral hemorrhage (ICH) with an ultra low chance of functional neurologic recovery. This study's aim is to validate the FUNC score and determine if it accurately identifies the cohort of patients with an ultra low chance of survival with good neurologic recovery.
  
  
  METHODS
  Retrospective review of 501 consecutive primary ICH patients admitted from the Emergency Department to a large healthcare system. Performance of the FUNC, ICH-GS, and oICH scores was determined by calculating areas under the receiver-operator-characteristic curves. Patients with a predicted 100 % chance of poor neurologic outcome (PNO) (FUNC <4 and ICH-GS >10) scores were evaluated to determine if DNR impacted 90 day survival or rate of survival with a Glasgow Outcome Score of <3.
  
  
  RESULTS
  In 366 cases of primary ICH who presented during the study period, 222(61 %) survived to discharge. Both the FUNC (AUC: 0.873) and ICH-GS (AUC: 0.888) outperformed the oICH (AUC: 0.743) in predicting 90-day mortality (p = <0.001). Of 68 patients with a FUNC score <4, 67 (98.5 %) had PNO at discharge. The presence of DNR was not associated with a significant difference in the rate of PNO at discharge (40/40 = 100 % vs. 27/28 = 96.4 % p = 0.42) or 90-day mortality (40/40 = 100 % vs. 21/28 = 75 %, p = 0.06).
  
  
  CONCLUSIONS
  The FUNC and ICH-GS appear superior to the oICH in predicting outcome in patients with primary ICH. In addition, the FUNC score appears to accurately identify patients with low chance of functional neurologic recovery at discharge.
authors.affiliation: Department of Emergency Medicine, Baylor University Medical Center, 3500 Gaston Avenue, Dallas, TX, 75246, USA, John.Garrett@baylorhealth.edu.
authors.forename: John S
authors.initials: JS
authors.lastname: Garrett
authors.forename: Mehrzad
authors.initials: M
authors.lastname: Zarghouni
authors.forename: Kennith F
authors.initials: KF
authors.lastname: Layton
authors.forename: Dion
authors.initials: D
authors.lastname: Graybeal
authors.forename: Yahya A
authors.initials: YA
authors.lastname: Daoud
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002543:Cerebral Hemorrhage / Q000401:mortality*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D063868:Patient Outcome Assessment; D011237:Predictive Value of Tests; D011379:Prognosis; D020127:Recovery of Function / Q000502:physiology; D012189:Retrospective Studies; D012720:Severity of Illness Index