gms | German Medical Science

Objective: Intracerebral hemorrhage (ICH) is a life threatening entity, and an early outcome assessment is mandatory for optimizing therapeutic efforts.

Methods: We retrospectively analyzed data from 342 patients with spontaneous primary ICH, treated in our institution in the last 8 years, to evaluate possible predictors of 30-day mortality considering clinical, radiological, and therapeutical parameters. Then we applied the three widely accepted outcome grading scoring systems [(ICH score, FUNC score and intracerebral hemorrhage grading scale (ICH-GS)] on our population to evaluate the correlation of these scores with the 30-day mortality.

Results: From 342 patients (mean age: 67 years, mean Glasgow Coma Scale [GCS] on admission: 9, mean ICH volume: 62.19 ml, most common hematoma location: basal ganglia [43.9%]), 102 received surgical and 240 conservative treatment. The 30-day mortality was 25.15%. In a multivariate analysis, basal GCS, bleeding volume and infratentorial hematoma location were significant predictors for the 30-day mortality. Regading the validatied outcome grading scores, we found, using Pearson correlation, a correlation of 0.986 between ICH score and 30-day mortality (P < 0.001), 0.853 between FUNC score and 30-day mortality (P = 0.001), and 0.924 between ICH-GS and 30-day mortality (P = 0.001).

Conclusion: Our study compared three validated outcome grading scores and showed that the ICH score and the ICH-GS accurately predict short-term mortality. The FUNC score, originally designed to estimate the 90-day outcome, correlated to a lesser degree with the mortality at 30 days in our study cohort.