Abstract W MP93: The STICH II Prognostic Score Predicts Outcomes in the ERICH Study
Introduction: The Surgical Trial in Lobar Intracerebral Hemorrhage (STICH II) investigators developed a pre-trial prognostic score based on Glasgow Coma Scale (GCS), age, and intracerebral hemorrhage (ICH) volume at randomization: 10 х GCS - age - 0·64 х ICH volume. The STICH II results demonstrate that lobar ICH subjects with a good prognostic score are more likely to have a good to moderate recovery. Our study implements this prognostic score in both lobar and deep supratentorial ICH in the Ethnic/Racial Variations of Intracerebral Hemorrhage (ERICH) cohort.
Methods: ERICH subjects with a supratentorial ICH, presenting GCS, ICH volume, and 6-month mRS are included in the analysis. Exclusion criteria are primary IVH cases and withdrawal of care patients at time of hospital discharge (comfort care or hospice). Based on STICH II, a good prognostic score is >27.672. We define a good outcome as 6-month mRS <=3. Prediction of outcome is analyzed using ordinal logistic regression with a cumulative logit link and positive and negative predictive values (PPV and NPV). An odds ratio (OR) is computed to estimate the effect size.
Results: A total of 584 subjects were included (mean age 60 years +/- 14.7; black 42%, Hispanic 32%, white 25%; 41% women). There were 392 (67.1%) deep ICH. The average ICH volume was 19.6 cc +/-22.8, and average GCS was 12.6 +/- 3.5. The prognostic score was predictive of mRS in both lobar (OR=5.5, p<0.0001) and deep (OR=6.3, p<0.0001) ICH (Table 1). PPV’s are lobar 71.5% and deep 68.1%; NPV’s are lobar 68.8% and deep 75.0%.
Conclusions: ERICH subjects with either lobar or deep ICH and a good prognostic score are more likely to have a good to moderate outcome, define in our study as a 6-month mRS <=3. In addition, the ICH subjects with a poor prognostic score are more likely have a poor outcome. Our findings suggest that the STICH II prognostic score may be applicable in other cohorts of both lobar and deep ICH.
Author Disclosures: J. Rasmussen: None. L. Birnbaum: Research Grant; Modest; NIH NS-069763. C.D. Langefeld: None. W.M. Brown: Research Grant; Modest; NIH NS-069763. C.J. Moomaw: Research Grant; Modest; NIH NS-069763. E. Nanez: Research Grant; Modest; NIH NS-069763. A. Vashkevich: Research Grant; Modest; NIH NS-069763. J. Rosand: Research Grant; Modest; NIH NS-069763. C.S. Kidwell: None. J. Osborne: Research Grant; Modest; NIH NS-069763. D. Woo: Research Grant; Modest; NIH NS-069763.
- © 2014 by American Heart Association, Inc.