Predictors of Poor Outcome at Hospital Discharge Following a Spontaneous Intracerebral Hemorrhage

ABSTRACT

Introduction: Spontaneous intracranial hemorrhage (S-ICH) often leads to significant morbidity and mortality. Clinical scoring systems can predict the mortality and functional outcome after ICH (FUNC score). FOUR score is a recently developed coma scale that incorporates brainstem reflexes. We propose that the combination of FUNC and FOUR scores will be a better prognostic indicator than either FUNC or FOUR score alone for S-ICH patients. Methods: We conducted a retrospective chart review of all S-ICH patients (>18 years of age) from January 2008 to May 2010. ICH volume was calculated using the ABC/2 formula. FUNC (≤5 or >5) and FOUR (≤10 and >10) scores were calculated from admission data. Statistical analyses included chi-square test, positive predictive value, and relative risk assessment. Results: Total number of patients was 92. The mean age of presentation was 64.6 ± 15.6 years (range: 27–95 years). Male to female ratio was 1.6:1. Combined FUNC score ≤ 5 and FOUR score ≤ 10 (F2 score; 95%) had higher positive predictive value for mortality than either FUNC score ≤ 5 (82%) or FOUR score ≤ 10 (81%). Conclusions: The combination of the FUNC and the FOUR scoring system is a better prognostication indicator for S-ICH patients than either FUNC or FOUR score.

KEYWORDS: :

• Cerebral hemorrhage
• death
• F2 score
• Full Outline of UnResponsiveness (FOUR) score
• FUNC score
• prognosis