Clinical Profile of Patients with Acute Intracerebral Hemorrhage and ICH Score as an Outcome Predictor on Discharge, 30 Days and 60 Days Follow-up.

Intracerebral Hemorrhage (ICH) is one of the most common causes of morbidity and mortality worldwide accounting for 10-15 % of all strokes types. ICH score is a validated tool to predict mortality and morbidity at 30 day follow up period.: To prospectively evaluate the predictive utility of ICH score in patients presenting with Acute ICH on discharge,30 days and 60 days follow-up period.Prospective observational study.This study was conducted in the Department of Neurology, Government Medical College, Kota, Rajasthan, India from January 2016 to August 2016. 120 consecutive patients presenting with acute ICH were studied. Data collected included demographics, clinical parameters, cranial Computed Tomography(CT) findings and ICH score on presentation. Primary outcome was defined as mortality/morbidity during hospitalisation, on discharge, 30 days and 60 days follow-up. Modified Rankin score (mRS) was used to assess the outcome.SPSS 19 statistical software.Of the total 120 patients with Acute ICH(108 supratentorial and 12 infratentorial) studied, 48(40%) patients died during hospitalisation. Mean age was 66.9 ± 13.5 Years. Hydrocephalus, midline shift and IV extension on presenting CT scan was observed in 20 (16.6%), 44 (36.6%) and 48 (40%)patients respectively. The independent predictors of increased mortality with statistical significance (p<0.001) were presence of vomiting, seizures, loss of consciousness, lower GCS (≤ 8), higher ICH score and ventilator requirement. Statistically significant (p≤0.001) radiological features associated with mortality included infratentorial location, presence of hydrocephalus,higher midline shift (58.3% vs 22.2% OR=2.6), intraventricular extension of hematoma and a higher baseline hematoma volume. ICH score on admission was significantly (p<0.001) positively correlated with the mRS score on discharge (R=0.667), 1 month (R=0.66) and 2 months (R=0.765) follow-up.ICH Score is a useful tool to predict outcome during hospitalisation, on discharge, 1 month and 2 month follow-up. We suggest that ICH score assessment and documentation should become standard procedure in acute care and follow up of patients with Intracerebral Hemorrhage.