J Med Assoc Thai Vol. 94 No. 12 2011 1471 Correspondence to: Chumnanvej S, Division of Neurosurgery, Surgery Department, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok 10400, Thailand. Phone: 0-2201-1315 E-mail: rasorayouth@mahidol.ac.th Outcome Predictor of Spontaneous Intracerebral Hemorrhage Management: Ten-Year Neurosurgical Experience at Ramathibodi Hospital Prasert Sarnvivad MD*, Sorayouth Chumnanvej MD* * Division of Neurosurgery, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand Objective: To determine the one-year outcome predictor for spontaneous intracerebral hemorrhage (sICH) patient population admitted to the Division of Neurosurgery, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand. This was also to provide a better understanding to assist physicians and caregivers in evaluating sICH survivors during this first year after treatment. Material and Method: The authors reviewed brain computed tomographic films and medical records of all sICH cases admitted at Ramathibodi Hospital, Mahidol University between 1999 and 2009. One-year outcome predictors were determined using multiple logistic regression statistical analyses. Results: There were 537 cases with sICH diagnosis between 1999 and 2009. However, 239 cases were collected after online medical record review and 138 completed medical record files were retrieved. Modified Rankin Scale (mRS) was used to determine the authors’ outcome treatment and categorized into two groups. The crucial group (mRS 5 and 6) and the favored group (mRS < 5) were compared. Volume of sICH and Initial hospitalization Glasgow Coma Scale were the significant predictors of one year treatment outcome for all locations of sICH. Using two classifications of intracerebral hemorrhage volume (less than 30 cc, and more than 30 cc) and three categories of the Glasgow Coma Scale (13-15, 9-12, and 8 or less), one year treatment outcome was predicted correctly with odd ratio and 95% confidence interval. Conclusion: Volume of sICH and initial hospitalization Glasgow Coma Scale is significantly influential to be one-year predictor in patients with sICH. The expectation of the treatment has to be discussed and planned for long-term management. Keywords: Spontaneous intracerebral hemorrhage, One-year outcome predictors, Survival In Thailand, the incidence of spontaneous intracerebral hemorrhage (sICH) is 30% of all strokes, while it accounts for 10 to 20% of all strokes in Western countries (1-8) . This incidence has a higher morbidity and mortality than cerebral infarction (6,9,10) . Around 30 to 50% of sICH patients expire in the first month (6,11) . To date, there is no proven benefit of surgical treatment in sICH. Several observational studies reported various prediction models and scales for ICH outcome (7,12-27) . The accessibility of validated reliable grading or scale is used as predictive tools of long-term clinical outcome in the present study. Various grading or scales are expected to improve reliability in sICH treatment. In order to assess the optimal outcome during the first year after treatment, modified Rankin Scale (mRS) is for the purpose of one-year outcome assessment. The authors conducted a retrospective study of sICH patients who were treated and followed-up for one year outcome. The objective of the present study was to determine one-year outcome predictor of sICH treatment in the patient population who were admitted in the Division of Neurosurgery, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand and were assessed by the modified Rankin Scale (mRS) at one year. Material and Method After an institutional review board (IRB) approval, the authors reviewed the brain computed tomographic films and medical records of all sICH cases in Ramathibodi Hospital, Mahidol University. The inclusion criteria are including patients age > 18 years J Med Assoc Thai 2011; 94 (12): 1471-5 Full text. e-Journal: http://www.jmat.mat.or.th