A Modified ICH Scoring Model to Predict Functional Outcomes in Primary Intracerebral Hemorrhage Survivors-Prospective Study

Abstract

Abstract Background Primary intracerebral hemorrhage (ICH) accounts for 85% of ICH and is associated with high morbidity and mortality. Researchers have developed several predictive models for mortality and functional outcomes for ICH since 2001. However, models that predict long-term functional outcomes of activities of daily living (ADL) among ICH survivors remain scarce. This study developed a modified ICH scoring system that incorporates body temperature to predict ADL functional outcomes 1 year after ICH and compared it with the original model. Methods This prospective observational study examined the functional outcomes for patients who received rehabilitation 1 year after primary ICH in a tertiary medical center between 2019 and 2021. This study excluded patients who died before discharge and those with ICH related to aneurysm, arteriovenous malformation, or trauma. Body temperature and comorbidities were incorporated into the original ICH score. Functional outcome was based on the modified Rankin Scale (mRS) score and the Barthel Index (BI). Severe dependency in ADL was defined by a BI of ≤60, and severe disability was defined by an mRS score of ≥4 at 1 year after ICH. Results A total of 100 patients were recruited. The modified ICH score was significantly associated with functional independence 1 year post-ICH, as measured by both the BI and mRS (p = 0.012 and 0.01, respectively). When predicting severe dependency at the 1 year follow-up, the modified ICH score had a higher area under the receiver operating characteristic curve (AUC) compared with the original ICH score, both in terms of BI (AUC = 0.8545 and 0.8417, respectively) and mRS (AUC = 0.8768 and 0.8466, respectively). Conclusions The present study developed a modified ICH score model that outperformed the original model in the prediction of ADL functional outcomes at 1 year. This is the first study to incorporate the effect of long-term rehabilitation into the development of the model.