Prognostic value of ICH score and ICH-GS score in Chinese intracerebral hemorrhage patients: analysis from the China National Stroke Registry (CNSR)

PLoS One. 2013 Oct 16;8(10):e77421. doi: 10.1371/journal.pone.0077421. eCollection 2013.


Purpose: No strong evidence of efficacy currently exists for different intracerebral hemorrhage (ICH) scoring system in predicting the prognosis of ICH in the Chinese population. This study aimed to test the accuracy of the ICH score and the ICH grading scale (ICH-GS) score in predicting the favorable prognosis in a large cohort of ICH patients in China.

Methods: This study was a multicenter, prospective cohort study. Patients diagnosed with ICH between September 2007 and August 2008 from the nationwide China National Stroke Registry (CNSR) database were screened and enrolled in this study. Demographics of the patients, treatments, mortality as well as the clinic and radiologic findings of ICH were collected. An ICH score and an ICH-GS score were evaluated for all the patients at admission. Follow-ups were conducted by phone at 3, 6 and 12 months after ICH onset. The modified Rankin scale (mRS) score was used to evaluate favorable functional outcome and was obtained at hospital discharge and during the 3-, 6- and 12-month follow-up visits.

Results: There were 410 (12.6%) in-hospital mortality out of a total of 3,255 ICH patients. The values of the Area Under Curve (AUC)at discharge, 3-, 6- and 12-month follow-up for ICH score were 0.72, 0.76, 0.76 and 0.75, respectively; while the numbers for the ICH-GS score were 0.71, 0.77, 0.78 and 0.78, respectively. At 6-month and 12-month follow-up, the ICH-GS score presented a significant better value in predicting favorable prognosis than did the ICH score (P=0.0003 and <0.0001, respectively).

Conclusion: Both the ICH and ICH-GS scores were effective inaccurately predicting the favorable functional outcome of ICH in the Chinese population. For mid-term and long-term prediction, the ICH-GS score was superior over the ICH score.

Publication types

  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Cerebral Hemorrhage / diagnosis*
  • Cerebral Hemorrhage / epidemiology*
  • China / epidemiology
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Middle Aged
  • Patient Outcome Assessment
  • Prognosis
  • Prospective Studies
  • Registries
  • Risk Factors
  • Time Factors
  • Trauma Severity Indices

Grant support

This study was sponsored by The capital health research and development of special (number capital 2011-2004-03) and the National Science and technology major special project (number 2011ZX09307-001-06). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.