Development and validation of a prognostic model to predict recovery following intracerebral hemorrhage

Abstract

While several models have been developed to predict mortality following intracerebral hemorrhage (ICH), the functional outcome and its predictors in surviving patients have been poorly investigated so far. To identify predictors and validate a prognostic model for independent functional outcome in patients with acute ICH. An inception cohort was assessed on the National Institutes of Health Stroke Scale (NIH-SS) at admission and followed-up after 100 days. 11 neurological departments with an acute stroke unit. 207 consecutive patients who were neither comatose nor intubated at admission within 6 hours after ICH and with complete follow-up. After 100 days, 40 patients (19.3 %) had died, 78 (37.7%) had regained functional independence (Barthel Index > or = 95) and 89 (43%) had survived but not recovered. In these patients, age and the NIH-SS total score were identified as independent predictors for functional independence after 100 days. With the predefined cut-off value, the prognosis of 79.8% of all patients could be predicted accurately upon validation in an independent data set of 173 non-comatose patients with acute ICH. Our study provides a validated prognostic model for prediction of complete recovery following ICH which could be very useful for the design of clinical studies.