Abstract
The main purpose of the study was to conduct the informative value of Intracerebral Hemorrhage Functional Outcome Score (ICH-FOS) assessment for the determination of a short-term vital prognosis in patients with spontaneous supratentorial intracerebral hemorrhage (SSICH). Materials and methods. A prospective, cohort study was conducted among 191 patients (117 men and 74 women, the mean age was 65.1 ± 0.8 years) with SSICH treated in a conservative manner. This study included clinical assessment (National Institute of Health Stroke Scale, Glasgow Coma Scale), neuroimaging and biochemistry examination. The ICH-FOS was used in order to conduct a complex assessment of the patients’ state severity on admission. The functional outcome of the SSICH acute period was assessed on the 21st day of the disease in accordance with the modified Rankin Scale. Results . Lethal outcome was noted in 22 patients (11.5 %). The patients with the lethal outcome during the acute period had a higher value of the ICH-FOS (8 (7–10) versus 4 (3–6), P 6 is the predictor of the lethal outcome in the acute period of SSICH (Se = 77.3 %; Sp = 81.1 %; AUC ± SE (95 % CI) = 0.86 ± 0.04 (0.80–0.91), P 6 (n = 49) lethal outcome was noted in 34.7 % of cases, whereas in the group of patients with the ICH-FOS value ≤6 (n = 142) it was noted only in 3.5 % of cases. Conclusions. The Intracerebral Hemorrhage Functional Outcome Sсore is a highly informative tool for the determination of a short-term vital prognosis of SSICH acute period outcome. The ICH-FOS >6 is associated with a 9.9-fold increased risk of lethal outcome (RR 95 % CI 3.8–25.3, P < 0.0001).
Highlights
Cerebral hemorrhagic stroke (CHS) and its most common form – spontaneous supratentorial intracerebral hemorrhage (SSICH) occupies a leading position in the structure of adult mortality causes in most countries of the world [1,4].One of the ways to reduce the mortality caused by this pathology is to develop a differentiated approach for the determination of optimal tactics of patient management in the acute period of the disease
Clinical sings of SSICH in the onset of the disease were characterized by a variable combination of focal neurolog ical
Lethal outcome was noted in 22 patients (11.5 %), unfavorable functional outcome in the form of the mRS score ≥3 on the 21st day of the disease was noted in 74 patients (38.7 %)
Summary
One of the ways to reduce the mortality caused by this pathology is to develop a differentiated approach for the determination of optimal tactics of patient management in the acute period of the disease. From this point of view, the verification of the short-term vital prognosis becomes especially significant, the latter being the basis for taking appropriate therapeutic and tactical decisions [3,5,12]. The Intracerebral Hemorrhage Functional Outcome Score (ICH-FOS) takes into consideration a set of clinical, neurological and neuroimaging examinations and biochemical analysis results in the onset of CHS. Recent studies have proved the informative value of this scale in order to determine a long-term functional outcome in patients with CHS [8]
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