Highlights
- •Outcome after ICH should be assessed taking into consideration multiple domains.
- •ICH carries a high short- and long-term mortality risk.
- •Patient reported outcomes should be increasingly reported in ICH patients.
- •Scores to predict survival, functional outcome and hematoma growth are available.
Abstract
Non-traumatic intracerebral hemorrhage (ICH) is associated with a significant global
burden of disease, and despite being proportionally less frequent than ischemic stroke,
in 2010 it was associated with greater worldwide disability-adjusted life years lost.
The focus of outcome assessment after ICH has been mortality in most studies, because
of the high early case fatality which reaches 40% in some population-based studies.
The most robust and consistent predictors of early mortality include age, severity
of neurological impairment, hemorrhage volume and antithrombotic therapy at the time
of the event. Long-term outcome assessment is multifaceted and includes not only mortality
and functional outcome, but also patient self-assessment of the health-related quality
of life, occurrence of cognitive impairment, psychiatric disorders, epileptic seizures,
recurrent ICH and subsequent thromboembolic events. Several scores which predict mortality
and functional outcome after ICH have been validated and are useful in the daily clinical
practice, however they must be used in combination with the clinical judgment for
individualized patients. Management of patients with ICH both in the acute and chronic
phases, requires health care professionals to have a comprehensive and updated perspective
on outcome, which informs decisions that are needed to be taken together with the
patient and next of kin.
Keywords
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Article info
Publication history
Published online: January 14, 2019
Accepted:
January 11,
2019
Received in revised form:
December 22,
2018
Received:
July 7,
2018
Identification
Copyright
© 2019 Elsevier B.V. All rights reserved.
