Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
PLoS One. 2013 Oct 16;8(10):e77421. doi: 10.1371/journal.pone.0077421. eCollection 2013.
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.
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.
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).
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.
目前尚无强有力的证据表明不同的脑出血（ICH）评分系统可准确预测中国人群 ICH 的预后。本研究旨在检验 ICH 评分和 ICH 分级量表（ICH-GS）评分在预测中国大型 ICH 患者良好预后中的准确性。
这是一项多中心前瞻性队列研究。从全国性的中国国家卒中登记数据库（CNSR）中筛选并纳入 2007 年 9 月至 2008 年 8 月期间诊断为 ICH 的患者。收集患者的人口统计学信息、治疗情况、死亡率以及 ICH 的临床和影像学发现。入院时对所有患者进行 ICH 评分和 ICH-GS 评分评估。ICH 发病后 3、6 和 12 个月通过电话进行随访。采用改良 Rankin 量表（mRS）评分评估良好的功能结局，在出院时和 3、6 和 12 个月随访时获得。
在总共 3255 例 ICH 患者中，有 410 例（12.6%）院内死亡。ICH 评分在出院时、3 个月、6 个月和 12 个月随访时的曲线下面积（AUC）值分别为 0.72、0.76、0.76 和 0.75，而 ICH-GS 评分的 AUC 值分别为 0.71、0.77、0.78 和 0.78。在 6 个月和 12 个月随访时，ICH-GS 评分在预测良好预后方面的价值明显优于 ICH 评分（P=0.0003 和 <0.0001）。
ICH 和 ICH-GS 评分均能有效预测中国人群 ICH 的良好功能结局，但在中期和长期预测方面，ICH-GS 评分优于 ICH 评分。
