Scoring System of Predictor of Outcome in SAH

Kim,  Gab Teug; Chang,  In Seung

J Korean Soc Emerg Med > Volume 8(3); 1997 > Article

Original Article

Journal of The Korean Society of Emergency Medicine 1997;8(3): 368-379.

Scoring System of Predictor of Outcome in SAH

ABSTRACT

We evaluated the ability of a simple scoring system for prediction of outcome soon after subarachnoid hemorrhage(SAH). The scoring system was calculated on the basis of the distribution of blood seen on the CT scan and patients' neurological grade on admission. Two points each were scored for interhemispheric, intraventricular, basal and intracerebral hemorrhage. We excluded hemorrhage in the Sylvian cistern from the calculation of the scoring system. Patients in neurological grade 1-3 scored -1, grade 4 scored 0, grades 5 & 6 scored +5. The CT score and grade score were summated to give the overall score. Patients were placed in 3 risk groups, low risk group in score of -1, medium risk group in score of 0-2, and high risk group in score above 3. The scoring system was applied prospectively to 134 patients who were admitted to our hospital from January 1995 to December 1996. The overall mortality rate was 32.1% within 3 months after onset of SAH. There was a close relationship between the patients' scores and their outcomes. Over 90% of low risk patients experienced a full and good recovery from the SAH compared to 30% of high risk patients. Less than 5% of low risk patients were died, whereas 56% of high risk group died. Thus a low risk patient has a better outcome than a high risk patient(p<0.001). The classification into risk groups has predictive value independent of angiographic finding, hypertension and vasospasm.