Abstract TP155: Predictive Values of Glasgow Coma Scale and National Institutes of Health Stroke Scale Scores in Determining 3-Month Outcomes of Patients With Intracerebral Hemorrhage

Abstract

Background: Intracerebral hemorrhage (ICH) is associated, with high rates of mortality, and long-term disability. We investigated the predictive values of the Glasgow Coma Scale (GCS) and National Institutes of Health Stroke Scale (NIHSS) in the prognosis of mortality and functional outcome in patients with ICH. Methods: A total of 1000 patients recruited in a clinical trial with acute were assessed using GCS and NIHSS at admission. Then, the receiver operating characteristic (ROC) curves were established, and the area under the curves of these 2 scoring systems was compared. The primary outcome was death or disability (modified Rankin scale (mRS) score of 4 to 6, on a scale ranging from 0 [no symptoms] to 6 [death]) at 3 months after randomization, as ascertained by an investigator who was unaware of the treatment assignments. Results: The area under the curve of GCS and NIHSS was 0.660 (95% confidence interval: 0.593-0.727) and 0.708 (95% confidence interval: 0.640-0.755), respectively, for predicting disability among survivors. The area under the curve was 0.655 (95% confidence interval: 0.621-0.688) and 0.788 (95% confidence interval: 0.759-0.817), respectively for prediction of 3-months death or disability among all patients with ICH. The GCS predicted 3-month disability among survivors with a sensitivity of 68.7% and a specificity of 57.7%, and the NIHSS predicted 3-month disability with a sensitivity of 74.6% and a specificity of 62.3%. The GCS predicted 3-month death or disability among all patients with a sensitivity of 60.5% and a specificity of 66.5%, and the NIHSS predicted 3-month death or disability with a sensitivity of 80.1% and a specificity of 66.8%. NIHSS (P<0.0001) and GCS (P=0.0002) scores had a statistically significant predictive value for the presence of intracerebral hemorrhage among survivors. Among all patients, NIHSS (P<0.0001) and GCS (P<0.0001) scores also had statistically significant predictive value for identifying patients at risk for death or disability at three months. Conclusions: GCS and NIHSS scales have good predictive values for the prognosis of patients with ICH as regards of mortality and disability. The NIHSS is more accurate than the GCS in predicting death or disability in patients with ICH.