The Diagnostic Utility of ICH-Score in Patients with Anticoagulant Related Intracerebral Hemorrhage

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Conference Proceeding

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Eur Stroke J


Background and Aims: Intracerebral hemorrhage (ICH) score presents a prognostic model of mortality among patients with spontaneous ICH of any cause, which has not been validated in patients with oral anticoagulant related ICH (OAC-ICH).We performed a post-hoc analysis of two prospective cohorts to estimate the diagnostic performance of ICH score in OAC-ICH related to the use of vitamin K antagonists (VKAICH) or non-vitamin K oral anticoagulants (NOAC-ICH). Methods: We identified the diagnostic accuracy and optimal cut-off in ICH score for the prognostication of 30-day mortality between NOACICH and VKA-ICH patients with receiver operating characteristic (ROC) curve analysis. Results: We included 108 NOAC-ICH and 241 VKA-ICH patients [mean age:74±10 years, 58% men, median NIHSS score:11 (4-21), median ICH-score:2 (1-3)]. A cut-off of 4 points in the ICH score was highlighted as the optimal threshold for the prognostication of 30-day mortality [sensitivity:57.7%, specificity:98.8% for NOAC-ICH; sensitivity: 42.1%, specificity:92.6% for VKA-ICH]. Overall, the predictive value of ICH-score was higher (p=0.001) in NOAC-ICH (AUC: 0.92, 95%CI: 0.86-0.98) compared to VKA-ICH (AUC: 0.77, 95%CI: 0.70-0.83; Figure). Conclusions: ICH score has satisfactory predictive value in the prognostication of 30-day mortality for OAC-ICH. The diagnostic yield of the score appears to be higher in NOAC-ICH than in VKA-ICH.



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