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68. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC)
7. Joint Meeting mit der Britischen Gesellschaft für Neurochirurgie (SBNS)

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

14. - 17. Mai 2017, Magdeburg

Does the original intracerebral hemorrhage (ICH) score or early poor outcome predict patients`outcomes at 12 months? A single center prospective study

Meeting Abstract

  • Motaz Hamed - Bonn, Deutschland
  • Patrick Schuss - Klinik und Poliklinik für Neurochirurgie, Bonn, Deutschland
  • Christiane Kaufhold - Bonn, Deutschland
  • Erdem Güresir - Klinik und Poliklinik für Neurochirurgie, Bonn, Deutschland
  • Matthias Schneider - Bonn, Deutschland
  • Hartmut Vatter - Rheinische Friedrich-Wilhelms-Universität, Neurochirurgische Klinik, Bonn, Deutschland
  • Azize Boström - Bonn, Deutschland

Deutsche Gesellschaft für Neurochirurgie. Society of British Neurological Surgeons. 68. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), 7. Joint Meeting mit der Society of British Neurological Surgeons (SBNS). Magdeburg, 14.-17.05.2017. Düsseldorf: German Medical Science GMS Publishing House; 2017. DocMi.25.07

doi: 10.3205/17dgnc541, urn:nbn:de:0183-17dgnc5417

Veröffentlicht: 9. Juni 2017

© 2017 Hamed et al.
Dieser Artikel ist ein Open-Access-Artikel und steht unter den Lizenzbedingungen der Creative Commons Attribution 4.0 License (Namensnennung). Lizenz-Angaben siehe



Objective: To evaluate the prognosis of poor early outcome in patients with spontaneous intracerebral hemorrhage (ICH) and to analyze mortality rates according the original ICH (oICH) score by Hemphill et al.

Methods: In a prospective observational data base the authors analyzed the outcomes of 105 patients with spontaneous intracerebral hemorrhage. Clinical condition was classified by the modified Ranking scale (mRS) at discharge, after 6 and 12 months, respectively. Factors possibly influencing outcomes (age, Glasgow Coma Scale, volume of hematoma, surgical versus conservative treatment) were investigated by statistical analyses. Mortality rates were calculated by the oICH score by Hemphill. Only patients with a follow up of at least 12 months were included. Poor early outcome was defined by a mRS of 5 at discharge.

Results: There were 56% male patients, mean age 68 yrs (median 71, range 18-98). 49.5% were treated conservatively. Fifty-three patients were treated by surgery including insertion of external ventricular drainage for the treatment of intracranial high pressure. Surgical therapy consisting of hematoma evacuation by craniotomy or catheter drainage with or without decompressive hemicraniectomy (DC) was performed in 21/53 cases. Altogether, 15 patients were treated by DC, 8/15 by DC plus hematoma evacuation and 7/15 by DC alone. The surgically treated patients presented significantly with older age, less GCS at admission and larger hematoma volume than the conservative group (p<0.5). At discharge 42 patients presented with mRS 5. 17/42 (40%) remained mRS 5 after 6 and 12 months, 33% had died, 12% of patients improved to mRS less than 4. Overall mortality at 12 months was 37%. According to the oICH, patients scored oICH5 showed 100% mortality, surprisingly, patients scored oICH2 and 3 had higher mortality rates than patients scored oICH4. Analysis of influencing factors showed a significantly higher proportion of conservatively treated patients in the oICH 2 group (3 surgical versus 16 conservative cases).

Conclusion: In this cohort, most patients with poor early outcome remain poor or die within the first 12 months (73%). This result may be helpful in decision making of aggressive therapy of this patient group according to patients will. Patients scored oICH 5 had 100% mortality, while oICH 2-4 cases had reciprocal mortality rates. This seems to be influenced most probably by aggressive treatment strategy.