• GartonAndrew L AALADepartment of Neurosurgery, New York-Presbyterian Hospital/Weill Cornell Medical Center, New York, New, York, USA. Electronic address: garton.ala@gmail.com., Vivek P Gupta, Saurabh Sudesh, Henry Zhou, Brandon R Christophe, and E Sander Connolly.
• Department of Neurosurgery, New York-Presbyterian Hospital/Weill Cornell Medical Center, New York, New, York, USA. Electronic address: garton.ala@gmail.com.
• World Neurosurg. 2020 Mar 1; 135: e573e579e573-e579.

BackgroundIntracerebral hemorrhage (ICH) remains a devastating diagnosis. While the ICH Score continues to be used in the clinical setting to prognosticate outcomes, contemporary improvements in management have reduced mortality rates for each scoring tier. The aims of this study were to examine mortality rates within ICH Score strata and examine if these findings are stable when major disability is included in categorizing poor outcomes.MethodsFrom a single-institution cohort built between 2009 and 2016, 582 patients were extracted based on the criteria for complete ICH Score, discharge mortality, and functional status for survivors. Mortality rates were stratified by ICH Score and compared with both historical and similar contemporary cohorts. Poor outcome was defined as severe disability (modified Rankin Scale score 5) in addition to death, stratified by ICH Score, and compared. A secondary analysis of patients with ICH Score of 2 was performed in light of the primary results.ResultsMortality rates stratified by ICH Score were notably lower than expected for low- and moderate-grade ICH compared with the original cohort. However, when defining a poor outcome as including severe disability (modified Rankin Scale score 5) in addition to death, the rates for poor outcomes were higher for patients with ICH Score of 2 (51.16% vs. 26%, P = 0.017) and no different for any other score group compared with the original cohort.ConclusionsThough the original ICH Score overestimates mortality for low-grade and moderate-grade hemorrhages, it may underpredict severe disability.Copyright © 2019 Elsevier Inc. All rights reserved.

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