Modifying the intracerebral hemorrhage score to suit the needs of the developing world

Ajay Hegde, Girish Menon

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Background: Published literature on intracerebral haemorrhage (ICH) from the Indian subcontinent is very scarce. The study aims to assess the prognostic factors influencing outcome and validating the ICH score which is widely used to prognosticate the disease in this financially constraint population. Prognosticating the outcome at the time of admission is important to customize treatment in a cost-effective manner. Materials and Methods: We conducted a prospective study of all Spontaneous ICH patients admitted from February 2015 to May 2016. Data pertaining to patient demographics, clinical findings, biochemical parameters and cranial computed tomography (CT) findings were recorded. MRS (modified Rankin score) was used to assess outcome at discharge and at three month follow up. Results: A total of 215 patients with hypertensive haemorrhage were analysed. The mean age of our cohort was 57.64 years and volume of bleed was 24.5ml. 73% pf patients with GCS<8, 46% with Intraventricular extension and 57% with hematoma volume >30 were died at the end of 3 months. Twenty eight patients succumbed during hospitalization while 38 died after their discharge. Mortality rates were 5%,16%, 33%, 54% and 93% for ICH Scores of 0, 1, 2, 3 and 4. The rICH score after modifying the age parameter in the ICH score to 70 years had mortality rates of 6%,15%,25%,51%,75% and 100%. Conclusion: ICH Score failed to accurately predict mortality in our cohort. ICH is predominately seen at a younger age group in our country and hence have better outcomes in comparison to the west. We propose a minor modification in the ICH score by reducing the age criteria by 10 years to prognosticate the disease better in our population.

Original languageEnglish
Pages (from-to)270-274
Number of pages5
JournalAnnals of Indian Academy of Neurology
Volume21
Issue number4
DOIs
Publication statusPublished - 01-10-2018

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Cerebral Hemorrhage
Mortality
Population
Hospitalization
Age Groups
Tomography
Demography
Prospective Studies
Hemorrhage
Costs and Cost Analysis

All Science Journal Classification (ASJC) codes

  • Clinical Neurology

Cite this

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title = "Modifying the intracerebral hemorrhage score to suit the needs of the developing world",
abstract = "Background: Published literature on intracerebral haemorrhage (ICH) from the Indian subcontinent is very scarce. The study aims to assess the prognostic factors influencing outcome and validating the ICH score which is widely used to prognosticate the disease in this financially constraint population. Prognosticating the outcome at the time of admission is important to customize treatment in a cost-effective manner. Materials and Methods: We conducted a prospective study of all Spontaneous ICH patients admitted from February 2015 to May 2016. Data pertaining to patient demographics, clinical findings, biochemical parameters and cranial computed tomography (CT) findings were recorded. MRS (modified Rankin score) was used to assess outcome at discharge and at three month follow up. Results: A total of 215 patients with hypertensive haemorrhage were analysed. The mean age of our cohort was 57.64 years and volume of bleed was 24.5ml. 73{\%} pf patients with GCS<8, 46{\%} with Intraventricular extension and 57{\%} with hematoma volume >30 were died at the end of 3 months. Twenty eight patients succumbed during hospitalization while 38 died after their discharge. Mortality rates were 5{\%},16{\%}, 33{\%}, 54{\%} and 93{\%} for ICH Scores of 0, 1, 2, 3 and 4. The rICH score after modifying the age parameter in the ICH score to 70 years had mortality rates of 6{\%},15{\%},25{\%},51{\%},75{\%} and 100{\%}. Conclusion: ICH Score failed to accurately predict mortality in our cohort. ICH is predominately seen at a younger age group in our country and hence have better outcomes in comparison to the west. We propose a minor modification in the ICH score by reducing the age criteria by 10 years to prognosticate the disease better in our population.",
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Modifying the intracerebral hemorrhage score to suit the needs of the developing world. / Hegde, Ajay; Menon, Girish.

In: Annals of Indian Academy of Neurology, Vol. 21, No. 4, 01.10.2018, p. 270-274.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Modifying the intracerebral hemorrhage score to suit the needs of the developing world

AU - Hegde, Ajay

AU - Menon, Girish

PY - 2018/10/1

Y1 - 2018/10/1

N2 - Background: Published literature on intracerebral haemorrhage (ICH) from the Indian subcontinent is very scarce. The study aims to assess the prognostic factors influencing outcome and validating the ICH score which is widely used to prognosticate the disease in this financially constraint population. Prognosticating the outcome at the time of admission is important to customize treatment in a cost-effective manner. Materials and Methods: We conducted a prospective study of all Spontaneous ICH patients admitted from February 2015 to May 2016. Data pertaining to patient demographics, clinical findings, biochemical parameters and cranial computed tomography (CT) findings were recorded. MRS (modified Rankin score) was used to assess outcome at discharge and at three month follow up. Results: A total of 215 patients with hypertensive haemorrhage were analysed. The mean age of our cohort was 57.64 years and volume of bleed was 24.5ml. 73% pf patients with GCS<8, 46% with Intraventricular extension and 57% with hematoma volume >30 were died at the end of 3 months. Twenty eight patients succumbed during hospitalization while 38 died after their discharge. Mortality rates were 5%,16%, 33%, 54% and 93% for ICH Scores of 0, 1, 2, 3 and 4. The rICH score after modifying the age parameter in the ICH score to 70 years had mortality rates of 6%,15%,25%,51%,75% and 100%. Conclusion: ICH Score failed to accurately predict mortality in our cohort. ICH is predominately seen at a younger age group in our country and hence have better outcomes in comparison to the west. We propose a minor modification in the ICH score by reducing the age criteria by 10 years to prognosticate the disease better in our population.

AB - Background: Published literature on intracerebral haemorrhage (ICH) from the Indian subcontinent is very scarce. The study aims to assess the prognostic factors influencing outcome and validating the ICH score which is widely used to prognosticate the disease in this financially constraint population. Prognosticating the outcome at the time of admission is important to customize treatment in a cost-effective manner. Materials and Methods: We conducted a prospective study of all Spontaneous ICH patients admitted from February 2015 to May 2016. Data pertaining to patient demographics, clinical findings, biochemical parameters and cranial computed tomography (CT) findings were recorded. MRS (modified Rankin score) was used to assess outcome at discharge and at three month follow up. Results: A total of 215 patients with hypertensive haemorrhage were analysed. The mean age of our cohort was 57.64 years and volume of bleed was 24.5ml. 73% pf patients with GCS<8, 46% with Intraventricular extension and 57% with hematoma volume >30 were died at the end of 3 months. Twenty eight patients succumbed during hospitalization while 38 died after their discharge. Mortality rates were 5%,16%, 33%, 54% and 93% for ICH Scores of 0, 1, 2, 3 and 4. The rICH score after modifying the age parameter in the ICH score to 70 years had mortality rates of 6%,15%,25%,51%,75% and 100%. Conclusion: ICH Score failed to accurately predict mortality in our cohort. ICH is predominately seen at a younger age group in our country and hence have better outcomes in comparison to the west. We propose a minor modification in the ICH score by reducing the age criteria by 10 years to prognosticate the disease better in our population.

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U2 - 10.4103/aian.AIAN-419-17

DO - 10.4103/aian.AIAN-419-17

M3 - Article

VL - 21

SP - 270

EP - 274

JO - Annals of Indian Academy of Neurology

JF - Annals of Indian Academy of Neurology

SN - 0972-2327

IS - 4

ER -