The Evaluation of Prognostic Scores in Spontaneous Intracerebral Hemorrhage in an Asian Population: A Retrospective Study Mervyn Jun Rui Lim , MBBS,* , † Arturo Yong Yao Neo, MBBS,† Gaurav Deep Singh, MBBS,† Yi Song Terence Liew, MBBS,† Maehanyi Frances Rajendram, MBBS,† Marcus Wei Xuan Tan, MBBS,† Tharun Ragupathi, MBBS,† Sein Lwin, FRCS,* Ning Chou, FRCS,* Vijay K. Sharma, MRCP,‡ and Tseng Tsai Yeo, FRCS* Objective: Clinical grading scales used for prognostication in spontaneous intracere- bral hemorrhage facilitate informed-decision making for resource-intensive inter- ventions. Numerous clinical prognostic scores are available for spontaneous intracerebral hemorrhage. However, these have not been validated well in Asian patients, and the most appropriate scoring system remains debatable. We evaluated the utility of clinical scores in prognosticating 30-day mortality and 90-day func- tional outcome in patients with spontaneous intracerebral hemorrhage. Materials and Methods: We conducted a retrospective review of all patients with spontaneous intracerebral hemorrhage admitted to our tertiary center from December 2014 to May 2016. Data on clinical presentation, imaging, and outcomes were extracted from electronic medical records using a standardized form. The data were analyzed for predictors of outcomes. Performance of prognostic scales was compared using receiver-operator characteristic statistics. Results: A total of 297 patients were included in the study. Mean age was 60.1 (SD 15.2) years and 190 (64.0%) were male. Thirty-two (10.8%) cases died within 30 days and 177 (62.8%) cases had poor functional outcome (modified Rankin scale of 3 or more) at 90 days. Dialysis depen- dency (OR=33.54, 95%CI=4.21À325.26, p=0.002), Glasgow coma scale (OR=0.76, 95%CI=0.64À0.88, p=0.001), hematoma volume (OR=1.02, 95%CI=1.00À1.04, p=0.027), and surgical evacuation (OR=0.15, 95%CI=0.02À0.66, p=0.024) were inde- pendent predictors for 30-day mortality. The original ICH score (0.862) and the ICH-Grading Scale (0.781) had the highest c-statistic for 30-day mortality and 90- day poor functional outcome respectively. Conclusions: Current prognostic scores performed acceptable-to-good in our patient cohort. Future studies may be useful to investigate the utility of these scores in clinical decision-making. Key Words: Intracerebral hemorrhage—Prognosis—Mortality—Patient outcome assessment—Cerebrovascular disease © 2020 Elsevier Inc. All rights reserved. From the *Division of Neurosurgery, University Surgical Cluster, National University Hospital, 5 Lower Kent Ridge Rd, Singapore 119074, Sin- gapore; †Ministry of Health Holdings, 1 Maritime Square, Singapore 099253, Singapore; and ‡Division of Neurology, University Medicine Cluster, National University Hospital, 5 Lower Kent Ridge Rd, Singapore 119074, Singapore. Received June 14, 2020; revision received September 20, 2020; accepted September 22, 2020. Grant Support: None. Address correspondence to Mervyn Lim Jun Rui, Division of Neurosurgery, University Surgical Cluster, 1E Kent Ridge Road, Level 8, Tower Block. S119228, Singapore 119074, Singapore. E-mail: mervynlim@u.nus.edu. 1052-3057/$ - see front matter © 2020 Elsevier Inc. All rights reserved. https://doi.org/10.1016/j.jstrokecerebrovasdis.2020.105360 Journal of Stroke and Cerebrovascular Diseases, Vol. 29, No. 12 (December), 2020: 105360 1