30-days’ outcome of haemorrhagic stroke: correlation between intracerebral hemorrhage score and modified Rankin score

Ah Sarder,B Basu,Bk Das,Kj Mondal,Ma Kabir,Mm Alam

doi:10.3329/mediscope.v5i1.36720

Abstract

Intracerebral hemorrhage (ICH) constitutes 10% to 15% of all strokes. Within 30 days reported mortality is 35-52% and only 20% is functionally independent in 6 months. Despite several existing outcome prediction models for ICH, modified Rankin scale is found to be best predictor of outcome in early and long term period. To find out 30-day mortality in ICH and predict outcome based on modified Rankin score. In this study, 48 patients presenting with acute ICH presenting to a tertiary hospital in Khulna were enrolled. The 30-day mortality and disability were recorded, and ICH score along with modified Rankin score at presentation were calculated. In this study, the 30-day mortality rate was 27.1%; regression analysis showed the correlation between the scores (as measured by modified Rankin scale) for patient disability, intraventricular hemorrhage, the Glasgow Coma score, and volume of hematoma (>30 ml vs <30 ml) were significantly correlated with corresponding ICH scores. The ICH scale is a simple clinical grading scale which can predict mortality as well as disability in haemorrhagic stroke within 30 days that can be helpful to physicians in prioritization of their patient management and forecasting about prognosis.Mediscope Vol. 5, No. 1: Jan 2018, Page 10-14

Highlights

Stroke can be defined as sudden developed neurological deficit focal or global, vascular in origin lasting for more than 24 hours or patient dies within this period
The volume of haemorrhage was measured by ‘ABC/2 x slice thickness’ formula in which A is the greatest diameter on the largest hemorrhage slice, B is the diameter perpendicular to A, and C is the approximate number of axial slices with hemorrhage multiplied by the slice thickness
Intraventricular haemorrhage was present in 52.1% of the patients and hematoma below tentorium cerebelli in 29.2% of the patients

Summary

Introduction

Stroke can be defined as sudden developed neurological deficit focal or global, vascular in origin (non-traumatic, non-epileptic) lasting for more than 24 hours or patient dies within this period. Stroke is one of the leading causes of death and acquired disability in adult around the world and largest burden for low and middle income countries.[1,2] A meta-analysis of stroke incidence in high- versus low- and middle-income countries shows that, there is 42.0% decrease in high-income countries and a greater than 100% increase in lowand middle-income countries.[3] Incidence in Bangladesh (2.6 per 1000 population)[4] is more than two times of that in the United Kingdom (1.0 per 1000 population)[5] and Bangladeshi people even after migration to United Kingdom, experience more stroke than the native people.

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