From the Guidelines
The mortality score for Intracerebral Hemorrhage (ICH) is 35% to 52% at 30 days.
Mortality Rate Breakdown
- The mortality rate varies by location of ICH, with 51% for deep hemorrhage, 57% for lobar, 42% for cerebellar, and 65% for brain stem at 1 year 1.
Key Statistics
- Half of the deaths from ICH occur in the first 2 days.
- Only 20% of patients who had an ICH are expected to be functionally independent at 6 months 1.
Location of ICH
- The location of ICH can be categorized into:
- Deep: 50% of cases
- Lobar: 35% of cases
- Cerebellar: 10% of cases
- Brain stem: 6% of cases 1.
From the Research
Mortality Score for Intracerebral Hemorrhage (ICH)
The mortality score for Intracerebral Hemorrhage (ICH) is based on the ICH score, which is a clinical grading scale that allows risk stratification on presentation with ICH. The ICH score is calculated based on the following factors:
- Glasgow Coma Scale score
- Age ≥80 years
- Infratentorial origin of ICH
- ICH volume ≥30 cm³
- Presence of intraventricular hemorrhage
Calculation of ICH Score
The ICH score is calculated by assigning points to each of the above factors, with a total score ranging from 0 to 5. The points are assigned as follows:
- GCS score 3 to 4 = 2 points
- GCS score 5 to 12 = 1 point
- GCS score 13 to 15 = 0 points
- Age ≥80 years = 1 point
- Infratentorial origin = 1 point
- ICH volume ≥30 cm³ = 1 point
- Intraventricular hemorrhage = 1 point
Predictive Value of ICH Score
The ICH score has been shown to be a reliable predictor of 30-day mortality in patients with ICH 2, 3. Studies have demonstrated that the ICH score is positively correlated with mortality, with higher scores indicating a higher risk of death 4, 5. The ICH score has also been shown to be useful in predicting functional outcome at discharge, 30 days, and 60 days follow-up 4.
Key Findings
- The ICH score is a simple and reliable clinical grading scale for ICH 3
- The ICH score is positively correlated with mortality and functional outcome 4, 5
- Higher ICH scores are associated with a higher risk of death and poor functional outcome 2, 4, 5
- The ICH score can be used to improve standardization of clinical treatment protocols and clinical research studies in ICH 3
Some of the evidence for the ICH score comes from the following studies: 2, 4, 6, 3, 5