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ICH Score

Predicts 30-day mortality after spontaneous intracerebral hemorrhage

Indication

  • Predicts 30-day mortality after spontaneous intracerebral hemorrhage

Criteria

  • id: gcs; label: GCS; type: options; options: label: 13-15; value: 0; label: 5-12; value: 1; label: 3-4; value: 2
  • id: volume; label: ICH volume; type: options; options: label: < 30 mL; value: 0; label: ≥ 30 mL; value: 1
  • id: ivh; label: Intraventricular hemorrhage (IVH); type: yesno
  • id: infratentorial; label: Infratentorial origin; type: yesno
  • id: age; label: Age ≥ 80 years; type: yesno

Interpretation

  • function(score) { var mortality = ['0%', '13%', '26%', '72%', '97%', '100%', '100%']; return { risk: 'ICH Score: ' + score + '/6', tier: 'Predicted 30-day Mortality: ' + (mortality[score] || '100%'), action: '30-day mortality: ' + (mortality[score] || '100%') + '. Neurosurgery consult. ICU admission. BP control (SBP <140 per INTERACT2). Reverse anticoagulation if applicable.', color: score <= 1 ? 'yellow' : 'red' }; }

Clinical pearls

  • ICH Score should NEVER be used to justify withdrawal of care — self-fulfilling prophecy of poor outcome
  • ABC/2 method for ICH volume estimation: (A × B × C) / 2 where A = largest diameter, B = perpendicular, C = number of slices with blood × slice thickness
  • SBP target <140 per INTERACT2 trial for spontaneous ICH

Source and review

  • Hemphill et al., Stroke 2001. Last reviewed: 2024-11-01