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ICH-GS (Intracerebral Hemorrhage, Glasgow Coma Scale) of Ruiz-Sandoval et al for Evaluating a Patient with a Primary Intracerebral Hemorrhage

Purpose: To evaluate a patient who has just had an intracerebral hemorrhage using the ICH-GS score of Ruiz-Sandoval et al.

Description

Ruiz-Sandova et al developed a score for evaluating a patient with intracerebral hemorrhage (ICH) based on the ICH score of Hemphill et al. This can help to identify a patient who may benefit from more aggressive management. The authors are from Hospital de Guadalajara "Fray Antonio Alcade" and the Universidad de Guadalajara in Mexico.


Outcomes: in-hospital mortality, good (Glasgow outcome scale IV or V) at 30 days, mortality at 30 days

 

Parameters:

(1) age in years

(2) Glasgow coma score (GCS) on admission to the hospital

(3) location of the intracerebral hemorrhage

(4) volume of the intracerebral hemorrhage

(5) extension into ventricles

 

Parameter

Finding

Points

age in years

< 45 years of age

1

 

45 to 64 years of age

2

 

>= 65 years of age

3

Glasgow coma score

13, 14 or 15

1

 

9, 10, 11 or 12

2

 

<= 8

3

location

supratentorial

1

 

infratentorial

2

volume

supratentorial and < 40 mL

1

 

supratentorial and 40 to 70 mL

2

 

supratentorial and > 70 mL

3

 

infratentorial and < 10 mL

1

 

infratentorial and 10 to 20 mL

2

 

infratentorial and > 20 mL

3

ventricular extension

absent

1

 

present

2

 

total ICH-GS score =

= SUM(points for all 5 parameters)

 

Interpretation:

• minimum score: 5

• maximum score: 13

• The higher the score the more severe the stroke.

 

Score

Good Outcome at 30 Days

In hospital mortality

30 day mortality

5

83%

12%

17%

6

76%

6%

8%

7

60%

13%

20%

8

27%

32%

43%

9

18%

57%

71%

10

4%

87%

87%

11

0%

97%

100%

12

0%

100%

100%

13

0%

100%

100%

 

Performance:

• The area under the ROC curve (AUC) is 0.86 to 0.88 for the various outcomes.


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Specialty

Objective

ICD-10