A Simple Scoring System for Selection of the Patients Requiring Surgical Intervention in Spontaneous Intracerebral Hemorrhage

Abstract

Background: Spontaneous intracerebral hemorrhage (ICH) is a relatively common disastrous medical emergency causing a significant amount of mortality and morbidity. To this date, no precise guideline has been proposed to select the optimal medical strategy, either surgical or medical, for these cases.

Materials and Methods: 1794 cases of spontaneous ICH where evaluated and 226 where included in this combined retrospective and prospective multi-centric analysis. The demographic and medical data in conjunction with 1-year follow-up GOS were meticulously analyzed and recorded. The patients were divided into medical and surgical groups based on the decision of the patient or his/her legal counterpart.

Results: After multivariate analysis age, history of diabetes mellitus and hypertension, volume of hemorrhage and GCS were recognized as the important prognostic factors and a scoring system was proposed according to these variables with a sensitivity of 86% and specificity of 73%.

Conclusion: Using this system can be of further assistance in order to draw an objective decision for spontaneous ICH cases. Certainly, these criteria should be verified in our stage II trial (prospective study).