Intracerebral Haemorrhage Score

The Intracerebral Haemorrhage (ICH) Score is a prognostic scoring system for predicting mortality among patients with spontaneous ICH.

The ICH score grades ICH severity and subsequent 30 day mortality, and so may help guide goals of care planning with patients’ families.

While the score can be a marker for ICH severity, it is not the only factor used to guide treatment options.

History

The ICH score was developed at the University of California, San Francisco Medical Center (UCSF), with the original study analysing 161 patients presenting with ICH to UCSF between 1997-1998


Scoring method
ParameterResultScore
Glasgow Coma Score (GCS)13–150
5–121
3–42
Age ≥ 80No0
Yes1
ICH volume ≥ 30 mLNo0
Yes1
Intraventricular haemorrhageNo0
Yes1
Origin of haemorrhageSupratentorial0
Infratentorial1

Interpretation:

ICH Score30-day mortality
00%
113%
226%
372%
494%
5100%
6100%
Management

Clinical decisions regarding interventions and goals of care are not made solely on the ICH score.

Other important factors such as patients’ and families’ wishes, baseline neurologic status, the nature of the bleed, the location of the bleed, and other co-morbidities are also taken into consideration.


References

Publications

FOAMed

Fellowship Notes

MBBS DDU (Emergency) CCPU. Adult/Paediatric Emergency Medicine Advanced Trainee in Melbourne, Australia. Special interests in diagnostic and procedural ultrasound, medical education, and ECG interpretation. Co-creator of the LITFL ECG Library. Twitter: @rob_buttner

Dr James Hayes LITFL author

Educator, magister, munus exemplar, dicata in agro subitis medicina et discrimine cura | FFS |

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