Abstract
Introduction:
The Intracerebral Hemorrhage (ICH) Score and Functional Outcome (FUNC) Score are prediction scales used to estimate outcome. These scales have not yet been validated in large minority cohorts. Our goal was to evaluate the predictive ability of the ICH and FUNC Score for white, black, and Hispanic patients.
Methods:
ERICH is an ongoing study of genetic and environmental risk factors for spontaneous ICH. The analysis included 847 cases enrolled prior to 1/1/2013 that had chart abstraction, baseline interview, CT imaging, GCS, and 3-month follow-up data available. Spearman’s rank correlation was used to assess the correlation between each score and 3-month modified Rankin Scale (mRS) score by ethnicity. Regression models were used to determine the predictive ability of each score.
Results:
Patients analyzed were 42% non-Hispanic black, 34% Hispanic, and 24% non-Hispanic white. Black and Hispanic subjects were younger compared with white subjects (p<.0001) and had higher proportions of deep ICH (p=.0013). Spearman’s rank correlations for ICH Score/FUNC Score and mRS at 3 months post ICH were 0.53/0.53 for black subjects, 0.66/0.63 for Hispanics, and 0.55/0.54 for whites. Both ICH and FUNC Scores had better predictive ability for minorities compared with whites (ICH Score, B = 0.87 black, 1.02 Hispanic, 0.76 white, p<.0001; FUNC Score, B = 0.56 black, 0.65 Hispanic, 0.49 white, p<.0001). Multiple regression demonstrated independent contributions by both scores for each ethnicity. Figure 1 demonstrates distribution of mortality by score.
Conclusions:
Both the ICH Score and FUNC Score were independently predictive of functional outcome at 3 months. Importantly, each score exhibits higher predictive ability in minority populations compared with whites. Whether or not this difference is attributed to minority status or baseline differences in age or ICH location requires further study.