30-day mortality by score
| ICH Score | 30-day mortality |
|---|---|
| 0 | 0% |
| 1 | 13% |
| 2 | 26% |
| 3 | 72% |
| 4 | 97% |
| 5 | 100% |
| 6 | 100% (estimated) |
Derivation cohort, n = 152 (Hemphill 2001). No patient scored 6, so that row is an estimate. These are group figures, not an individual prognosis.
Score & evidence
Score
GCS 3 to 4 2
GCS 5 to 12 1
GCS 13 to 15 0
ICH volume 30 cm³ or more 1
Intraventricular haemorrhage 1
Infratentorial origin 1
Age 80 years or older 1
Total 0 to 6
ABC/2 volume
Volume (cm³) = A × B × C ÷ 2
A diameter on the axial image (cm)
B diameter on the coronal image (cm)
C diameter on the sagittal image (cm)
- The three diameters must be at right angles to each other, or one direction is counted twice.
- Kothari’s original method takes the third diameter from the number of slices with haemorrhage × slice thickness. Measuring it directly on a reformat gives the same length without counting thin slices.
Read with care
- The mortality figures come from 152 patients at one centre in 1997–98. They describe groups, not what will happen to one patient.
- The score has also been validated for functional outcome at 12 months (Hemphill 2009).
- The 2022 AHA/ASA guideline: baseline severity scales give an overall measure of haemorrhage severity but should not be used as the sole basis for limiting life-sustaining treatments.
References
Hemphill JC 3rd, Bonovich DC, Besmertis L, Manley GT, Johnston SC. The ICH score: a simple,
reliable grading scale for intracerebral hemorrhage. Stroke 2001;32(4):891–7.
doi:10.1161/01.str.32.4.891
Kothari RU, Brott T, Broderick JP, et al. The ABCs of measuring intracerebral hemorrhage
volumes. Stroke 1996;27(8):1304–5.
doi:10.1161/01.str.27.8.1304
Hemphill JC 3rd, Farrant M, Neill TA Jr. Prospective validation of the ICH Score for
12-month functional outcome. Neurology 2009;73(14):1088–94.
doi:10.1212/WNL.0b013e3181b8b332
Greenberg SM, Ziai WC, Cordonnier C, et al. 2022 guideline for the management of patients
with spontaneous intracerebral hemorrhage (AHA/ASA). Stroke 2022;53(7):e282–e361.
doi:10.1161/STR.0000000000000407