The Intracerebral Hemorrhage Score Overestimates Mortality in Young Adults

Jason Maljaars; Aayushi Garg; Vaelan Molian; Enrique C Leira; Harold P Adams; Amir Shaban

doi:10.1016/j.jstrokecerebrovasdis.2021.105963

Back

The Intracerebral Hemorrhage Score Overestimates Mortality in Young Adults

Journal article

Peer reviewed

The Intracerebral Hemorrhage Score Overestimates Mortality in Young Adults

Jason Maljaars, Aayushi Garg, Vaelan Molian, Enrique C Leira, Harold P Adams and Amir Shaban

Journal of stroke and cerebrovascular diseases, Vol.30(9), pp.105963-105963

09/2021

DOI: 10.1016/j.jstrokecerebrovasdis.2021.105963

PMID: 34247055

View Online

Abstract

To determine whether the intracerebral hemorrhage (ICH) score is accurate in predicting 30-day mortality in young adults, we calculated the ICH score for 156 young adults (aged 18-45) with primary spontaneous ICH and compared predicted to observed 30-day mortality rates. We retrospectively reviewed all patients aged 18-45 consecutively presenting to the University of Iowa from 2009 to 2019 with ICH. We calculated the ICH score and recorded its individual subcomponents for each patient. Poisson regression was used to test the association of ICH score components with 30-day mortality. We identified 156 patients who met the inclusion criteria; mean± standard deviation (SD) age was 35±8 years. The 30-day mortality rate was 15% (n=24). The ICH score was predictive of 30-day mortality for each unit increase (p= 0.04 for trend), but the observed mortality rates for each ICH score varied considerably from the original ICH score predictions. Most notably, the 30-day mortality rates for ICH scores of 1, 2, and 3 are predicted to be 13%, 26%, and 72% respectively, but were observed in our population to be 0%, 3%, and 41%. An ICH volume of >30cc [relative risk (RR) 28, 95% confidence intervals (CI) 3-315, p=0.01] and a GCS score of <5 (RR 13, 95% CI 0.1-1176, p=0.01) were independently associated with 30-day mortality. The ICH score tends to overestimate mortality in young adults. ICH volume and GCS score are the most relevant items in predicting mortality at 30 days in young adults.

Intracerebral hemorrhage score

Stroke in the young

Mortality

Intracerebral hemorrhage

Details

Title: Subtitle: The Intracerebral Hemorrhage Score Overestimates Mortality in Young Adults
Creators: Jason Maljaars - Departments of Neurology, Carver College of Medicine, 200 Hawkins Dr., Iowa City, IA 52242, USA
Aayushi Garg - Departments of Neurology, Carver College of Medicine, 200 Hawkins Dr., Iowa City, IA 52242, USA
Vaelan Molian - Departments of Neurology, Carver College of Medicine, 200 Hawkins Dr., Iowa City, IA 52242, USA
Enrique C Leira - Departments of Neurology, Carver College of Medicine, 200 Hawkins Dr., Iowa City, IA 52242, USA
Harold P Adams - Departments of Neurology, Carver College of Medicine, 200 Hawkins Dr., Iowa City, IA 52242, USA
Amir Shaban - Departments of Neurology, Carver College of Medicine, 200 Hawkins Dr., Iowa City, IA 52242, USA
Resource Type: Journal article
Publication Details: Journal of stroke and cerebrovascular diseases, Vol.30(9), pp.105963-105963
DOI: 10.1016/j.jstrokecerebrovasdis.2021.105963
PMID: 34247055
NLM abbreviation: J Stroke Cerebrovasc Dis
ISSN: 1052-3057
eISSN: 1532-8511
Publisher: Elsevier Inc
Language: English
Date published: 09/2021
Academic Unit: Neurology; Epidemiology; Iowa Neuroscience Institute; Neurosurgery
Record Identifier: 9984104792502771

Metrics

13 Record Views

2 Times Cited - Web of Science

See more details