Development and validation of a prognostic model to predict recovery following intracerebral hemorrhage

Abstract

Context: While several models have been developed to predict mortality following intracerebral hemorrhage (ICH), the functional outcome and its predictors in surviving patients have been poorly investigated so far.

Objectives: To identify predictors and validate a prognostic model for independent functional outcome in patients with acute ICH.

Design: An inception cohort was assessed on the National Institutes of Health Stroke Scale (NIH-SS) at admission and followed-up after 100 days.

Setting: 11 neurological departments with an acute stroke unit.

Patients: 207 consecutive patients who were neither comatose nor intubated at admission within 6 hours after ICH and with complete follow-up.

Results: After 100 days, 40 patients (19.3 %) had died, 78 (37.7%) had regained functional independence (Barthel Index > or = 95) and 89 (43%) had survived but not recovered. In these patients, age and the NIH-SS total score were identified as independent predictors for functional independence after 100 days. With the predefined cut-off value, the prognosis of 79.8% of all patients could be predicted accurately upon validation in an independent data set of 173 non-comatose patients with acute ICH.

Conclusion: Our study provides a validated prognostic model for prediction of complete recovery following ICH which could be very useful for the design of clinical studies.