The ICH Score: Predicting Mortality and Functional Outcome in an Asian Population

To the Editor: We were impressed by the simplicity yet apparent accuracy of the ICH scoring system proposed by Hemphill and coworkers.1 The score included factors that were found to be independent predictors of poor prognosis not only in their data set but in most other previously published studies as well. In response to their call for its validation in an independent cohort, Fernandes et al2 tested the score on 393 patients admitted to their neurosurgical unit in the United Kingdom. While ICH score was predictive of mortality at neurosurgical discharge, they felt that it was not as useful in predicting independent recovery because of a high rate of unfavorable outcome (severe disability, death, or vegetative state) even at a score of 2. We were interested to see whether the proposed ICH score will prove valid in predicting not only mortality but also eventual functional outcome in our Asian population. Our local data show that intracerebral hemorrhage accounts for approximately 21% of hospitalized stroke cases. For the year 2001, we prospectively collected data on 302 patients with spontaneous ICH consecutively admitted to two major …