24-Hour ICH Score Is a Better Predictor of Outcome than Admission ICH Score.
BACKGROUND
The ICH score is a validated tool for predicting 30-day morbidity and mortality in patients with intracerebral hemorrhage.


OBJECTIVE
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, andP= 0.018), but ICH score on admission was not (OR = 2.14, 95% CI 0.88-5.24, andP= 0.095).


CONCLUSIONS
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.
Stroke Program, Department of Neurology, Tulane University Hospital, 1440 Canal Street, TB-52, Suite 1000, New Orleans, LA 70112-2715, USA; Neurovascular Service and Neurocritical Care, Department of Neurology, University of California, San Francisco, CA 94143, USA.
Aimee M
AM
Aysenne
Health Services and Outcomes Research Center for Outcome and Effectiveness Research and Education (COERE), University of Alabama at Birmingham, Birmingham, AL 35249, USA; Center 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; School of Public Health, Department of Epidemiology, University of Alabama at Birmingham, Birmingham, AL 35249, USA.
Karen C
KC
Albright
Stroke Program, Department of Neurology, Tulane University Hospital, 1440 Canal Street, TB-52, Suite 1000, New Orleans, LA 70112-2715, USA.
Tiffany
T
Mathias
Stroke Program, Department of Neurology, Tulane University Hospital, 1440 Canal Street, TB-52, Suite 1000, New Orleans, LA 70112-2715, USA; Division of Neurosciences Critical Care, Department of Anesthesia Critical Care Medicine, Johns Hopkins University, Baltimore, MD 21287, USA.
Tiffany R
TR
Chang
School of Public Health, Department of Epidemiology, University of Alabama at Birmingham, Birmingham, AL 35249, USA; School of Medicine, Department of Neurology, University of Alabama at Birmingham, Birmingham, AL 35249, USA.
Amelia K
AK
Boehme
Department of Biostatistics, School of Public Health, University of Alabama at Birmingham, Birmingham, AL 35294, USA.
T Mark
TM
Beasley
Stroke Program, Department of Neurology, Tulane University Hospital, 1440 Canal Street, TB-52, Suite 1000, New Orleans, LA 70112-2715, USA.
Sheryl
S
Martin-Schild
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