BRIEF REPORT

Is the ICH score a valid predictor of mortality in intracerebral hemorrhage?

Meyer, Dawn M. PhD¹; Begtrup, Kamilla MSc²; Grotta, James C. MD³ Recombinant Activated Factor VII Intracerebral Hemorrhage Trial Investigators

Author Information

¹Department of Neurosciences, University of California San Diego, La Jolla, California

²Novo Nordisk A/S, Bagsvaerd, Denmark

³University of Texas Health Science Center at Houston, Houston, Texas

⁴NIH-NINDS, Bethesda, Maryland

(Assistant Professor)

(Biostatistician)

(Chair, Neurology Department)

Received: 24 September 2013; accepted: 27 January 2014

Published online 24 January 2015.

Correspondence Dawn M. Meyer, PhD, Department of Neurosciences, University of California San Diego, 200 West Arbor Srive, San Diego, CA 92103. Tel: 619–543–2871; Fax: 619–543–7771; E-mail: [email protected]

Disclosures K. Begtrup is a stock holder and employee of Novo Nordisk. D. M. Meyer and J. C. Grotta have no conflicts of interest related to this manuscript.

Journal of the American Association of Nurse Practitioners 27(7):p 351-355, July 2015. | DOI: 10.1002/2327-6924.12198

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Abstract

Purpose:

The intracerebral hemorrhage (ICH) score utilizes a 0- to 6-point scoring system to predict 30-day mortality in ICH patients. The purpose of this analysis was to (a) validate the ICH score in an international, heterogeneous population of ICH patients; and (b) assess the usefulness of a 72-h ICH score.

Data sources:

Analyses were based on data from 399 patients in the Novo Nordisk trial F7ICH-1371. The ICH score's ability to predict mortality was determined by calculating the sensitivity, specificity, and positive predictive value (PPV).

Conclusions:

Both the baseline and 72-h ICH score had high specificity but low sensitivity resulting in an overall PPV of 57%–76%. Specificity of the ICH score was higher in the baseline ICH score (95%) as compared to the 72-h score (89%). Sensitivity of the ICH score was higher in the 72-h ICH score (75%) as compared to the baseline score (36%).

Implications for practice:

The baseline ICH score provides reasonable PPV while the 72-h score provides higher sensitivity. ICH scores obtained at baseline and/or 72 h are valid and may help practitioners to more accurately predict 30-day mortality in ICH patients.