Skip to main content

Advertisement

Log in

Validation of the ICH score and ICH-GS in a Peruvian surgical cohort: a retrospective study

  • Original Article
  • Published:
Neurosurgical Review Aims and scope Submit manuscript

Abstract

The intracerebral hemorrhage (ICH) score and the ICH-grading scale (ICH-GS) are mortality predictor tools developed predominantly in conservatively treated ICH cohorts. We aimed to compare and evaluate the external validity of both models in predicting mortality in patients with ICH undergoing surgical intervention. A retrospective review of all patients presenting with spontaneous ICH admitted to a Peruvian national hospital between January 2018 and March 2020 was conducted. We compared the area under the receiver operating characteristic curve (AUC) for the ICH score and ICH-GS for in-hospital, 30-day, and 6-month mortality prediction. The research protocol was approved by the Institutional Review Board. A total of 73 patients (median age 62 years, 56.2% males) were included in the study. The mean ICH and ICH-GS scores were 2.5 and 8.7, respectively. In-hospital, 30-day, and 6-month mortality were 37%, 27.4%, and 37%, respectively. The AUC for in-hospital, 30-day, and 6-month mortality was 0.69, 0.71, and 0.69, respectively, for the ICH score and 0.64, 0.65, and 0.68, respectively, for the ICH-GS score. In this study, the ICH score and ICH-GS had moderate discrimination capacities to predict in-hospital, 30-day, and 6-month mortality in surgically treated patients. Additional studies should assess whether surgical intervention affects the discrimination of these prognostic models in order to develop predictive scores based on specific populations.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

Data availability

The data that support the findings of this study are available from the corresponding author on reasonable request.

References

  1. van Asch CJ, Luitse MJ, Rinkel GJ, van der Tweel I, Algra A, Klijn CJ (2010) Incidence, case fatality, and functional outcome of intracerebral haemorrhage over time, according to age, sex, and ethnic origin: a systematic review and meta-analysis. Lancet Neurol 9:167–176

    Article  Google Scholar 

  2. Pinho J, Costa AS, Araújo JM, Amorim JM, Ferreira C (2019) Intracerebral hemorrhage outcome: a comprehensive update. J Neurol Sci 398:54–66

    Article  Google Scholar 

  3. Hemphill JC, Greenberg SM, Anderson CS, Becker K, Bendok BR, Cushman M, Fung G, Goldstein J, Macdonald R, Michell P et al (2015) Guidelines for the management of spontaneous intracerebral hemorrhage: a guideline for healthcare professionals from the American Heart Association/American Stroke Association. Stroke 46:2032–2060

    Article  Google Scholar 

  4. Steiner T, Al-Shahi Salman R, Beer R, Christensen H, Cordonnier C, Csiba L, Forsting M, Harnof S, Klijn C, Krieger D et al (2014) European Stroke Organisation (ESO) guidelines for the management of spontaneous intracerebral hemorrhage. Int J Stroke 9:840–855

    Article  Google Scholar 

  5. Gregório T, Pipa S, Cavaleiro P, Atanásio G, Albuquerque I, Chaves PC, Azevedo L (2018) Prognostic models for intracerebral hemorrhage: systematic review and meta-analysis. BMC Med Res Methodol 18:145

    Article  Google Scholar 

  6. Hwang BY, Appelboom G, Kellner CP, Carpenter AM, Kellner MA, Gigante PR, Conolly ES (2010) Clinical grading scales in intracerebral hemorrhage. Neurocrit Care 13:141–151

    Article  Google Scholar 

  7. Hemphill JC, Bonovich DC, Besmertis L, Manley GT, Johnston SC (2001) The ICH score: a simple, reliable grading scale for intracerebral hemorrhage. Stroke 32:891–896

    Article  Google Scholar 

  8. Ruiz-Sandoval JL, Chiquete E, Romero-Vargas S, Padilla-Martínez JJ, González-Cornejo S (2007) Grading scale for prediction of outcome in primary intracerebral hemorrhages. Stroke 38:1641–1644

    Article  Google Scholar 

  9. Gregório T, Pipa S, Cavaleiro P, Atanásio G, Albuquerque I, Castro Chaves P, Azevedo L (2019) Original intracerebral hemorrhage score for the prediction of short-term mortality in cerebral hemorrhage: systematic review and meta-analysis. Crit Care Med 47:857–864

    Article  Google Scholar 

  10. Goksuluk D, Korkmaz S, Zararsiz G, Karaagaoglu AE (2016) EasyROC: an interactive web-tool for roc curve analysis using r language environment. R J 8:213–230

    Article  Google Scholar 

  11. Hemphill JC, Farrant M, Neill TA (2009) Prospective validation of the ICH Score for 12-month functional outcome. Neurology 73:1088–1094

    Article  Google Scholar 

  12. Swets JA (1988) Measuring the accuracy of diagnostic systems. Science 240:1285–1293

    Article  CAS  Google Scholar 

  13. Gregório T, Pipa S, Cavaleiro P, Atanásio G, Albuquerque I, Chaves PC, Azevedo L (2019) Assessment and comparison of the four most extensively validated prognostic scales for intracerebral hemorrhage: systematic review with meta-analysis. Neurocrit Care 30:449–466

    Article  Google Scholar 

  14. Altman DG, Vergouwe Y, Royston P, Moons KGM (2009) Prognosis and prognostic research: validating a prognostic model. BMJ 338:1432–1435

    Article  Google Scholar 

  15. Hemingway H, Riley RD, Altman DG (2010) Ten steps towards improving prognosis research. BMJ 340:410–414

    Article  Google Scholar 

  16. Abdallah A, Chang JL, O’Carroll CB, Okello S, Olum S, Acan M, Abdi A, Chow FC, Siedner MJ (2018) Validation of the intracerebral hemorrhage score in Uganda: a prospective cohort study. Stroke 49:3063–3066

    Article  Google Scholar 

  17. Puneeth UM, Bhatia R, Sreenivas V, Singh N, Joseph R, Dash D, Singh RJ, Tripathi M, Padma MV et al (2019) Validation of ICH and ICH-GS scores in an Indian cohort: impact of medical and surgical management. J Stroke Cerebrovasc Dis 28:2213–2220

    Article  Google Scholar 

  18. Bin KD, Park SK, Moon BH, Cho BR, Jang DK, Jang KS (2018) Comparison of craniotomy and decompressive craniectomy in large supratentorial intracerebral hemorrhage. J Clin Neurosci 50:208–213

    Article  Google Scholar 

  19. Lim MJR, Neo AYY, Singh GD, Liew YST, Rajendram MF, Tan MWX, Ragupathi T, Lwin S, Chou N, Sharma V et al (2020) The evaluation of prognostic scores in spontaneous intracerebral hemorrhage in an Asian population: a retrospective study. J Stroke Cerebrovasc Dis 29:105360

    Article  Google Scholar 

  20. Nisar T, Alchaki A, Hillen M (2018) Validation of ICH score in a large urban population. Clin Neurol Neurosurg 174:36–39

    Article  Google Scholar 

  21. Ji R, Shen H, Pan Y, Wang P, Liu G, Wang Y, Li H, Zhao X, Wang Y (2013) A novel risk score to predict 1-year functional outcome after intracerebral hemorrhage and comparison with existing scores. Crit Care 17:R275

    Article  Google Scholar 

  22. Bruce SS, Appelboom G, Piazza M, Hwang BY, Kellner C, Carpenter AM, Bagiella E, Mayer S, Connolly ES (2011) A comparative evaluation of existing grading scales in intracerebral hemorrhage. Neurocrit Care 15:498–505

    Article  Google Scholar 

  23. Fahlström A, Redebrandt HN, Zeberg H, Bartek J, Bartley A, Tobieson L, Erkki M, Hessington A, Troberg E, Mirza S et al (2020) A grading scale for surgically treated patients with spontaneous supratentorial intracerebral hemorrhage: the Surgical Swedish ICH Score. J Neurosurg 133:800–807

    Article  Google Scholar 

  24. Hong S, Maruyama K, Noguchi A, Hirano T, Nagane M, Shiokawa Y (2021) Is using intracerebral hemorrhage scoring systems valid for mortality prediction in surgically treated patients? Neurosurg Rev. https://link.springer.com/article/10.1007%2Fs10143-020-01451-8

Download references

Acknowledgements

We thank Dr. John F. Vargas Urbina and Gianfranco Reyes Narro for their contribution in data recollection.

Author information

Authors and Affiliations

Authors

Contributions

All authors contributed to the study conception and design. Material preparation, data collection, and analysis were performed by Aaron Rodriguez Calienes, Marco Malaga, and Giancarlo Saal Zapata. The first draft of the manuscript was written by Aaron Rodriguez Calienes and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

Corresponding authors

Correspondence to Carlos Alva-Diaz or Giancarlo Saal-Zapata.

Ethics declarations

Ethics approval

Ethical approval was waived by the local Ethics Committee of Hospital Nacional Guillermo Almenara Irigoyen in view of the retrospective nature of the study and all the procedures being performed were part of the routine care.

Consent to participate

Not applicable.

Consent for publication

Not applicable.

Conflict of interest

The authors declare no competing interests.

Additional information

Publisher’s note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Supplementary Information

Below is the link to the electronic supplementary material.

Supplementary file1 (DOCX 26 KB)

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Rodriguez-Calienes, A., Malaga, M., Alva-Diaz, C. et al. Validation of the ICH score and ICH-GS in a Peruvian surgical cohort: a retrospective study. Neurosurg Rev 45, 763–770 (2022). https://doi.org/10.1007/s10143-021-01605-2

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10143-021-01605-2

Keywords

Navigation