Background and Purpose
Prior studies of intracerebral hemorrhage (ICH) outcome prediction models have not systematically included adjustment for comorbid conditions. The purpose of this study was to assess whether the Charlson Comorbidity Index (CCI), was associated with early mortality and long-term functional outcome in patients with intracerebral hemorrhage.
We performed a retrospective analysis on a prospective observational cohort of patients with ICH admitted to two UCSF hospitals from 6/1/2001-5/31/2004. Components of the ICH Score and use of early care limitations were recorded. Outcome was assessed using the modified Rankin Scale (mRS) out to 12-months. The CCI was derived using hospital discharge ICD-9 CM codes and patient history obtained from standardized case report forms.
In this cohort of 243 ICH patients comorbid conditions were common, with CCI scores ranging from 0 to 12. Only 29% of patients with high CCI scores (≥3) achieved a 12-month mRS score of 3 or better compared with 48% of patients with CCI scores of 0 (p=0.02). CCI score was independently predictive of 12-month functional outcome, with higher CCI having a greater impact (CCI=2, OR=2.3, p=0.06; CCI ≥3, OR=3.5, p=0.001).
Comorbid medical conditions as measured by the CCI independently influence outcome after ICH. Future ICH outcome studies should account for the impact of comorbidities on patient outcome.
Keywords: Intracerebral hemorrhage, Charlson Comorbidity Index, Stroke Outcome, Comorbidity