Background and

Purpose: Patients with intracerebral hemorrhage (ICH) are commonly monitored in an intensive care unit (ICU), however, objective data guiding need for ICU admission and prediction of ICU needs are largely lacking In the COVID era, judicious use of critical care resources is of particular importance as strained health care systems may face the challenge of triaging critically ill ICH patients in a resource-constraint environment Our study aimed to develop a feasible risk score to identify ICH patients at low risk for critical care

Methods: We retrospective analyzed data from 451 ICH patients between 2010 and 2018 The sample was randomly divided in a development and a validation cohort Logistic regression was used to develop a risk score by weighting independent predictors of ICU needs based on strength of association

Results: The rate of ICU interventions was 80 3% Systolic blood pressure (SBP), Glasgow Coma Scale (GCS), intraventricular hemorrhage (IVH), and ICH volume were independent predictors of critical care The following points were assigned for the risk score: SBP 160-190 mm Hg (1 point), SBP & gt; 190 mm Hg (3 points); GCS 8-13 (1 point), GCS 40 cm3 (2 points); presence of IVH (1 point) The score ranges from 0-9 In the validation group, the score achieved an AUC of 0 880 (95% CI 0 833-0 928) A score of & lt; 2 predicted absence of critical care needs with 65 2% sensitivity and 89 2% specificity, and a score of & lt; 3 predicted absence of critical care needs with 86 5% sensitivity and 79 8% specificity Among patients with a score of 0 and no ICU needs during their ED stay , 93 6% remained without critical care needs Conclusion: Our score, combining information about SBP, GCS, IVH, and ICH volume, may be a useful predictor of ICU needs in ICH Our score identifies ICH patients at low risk for critical care, and patients with a score & lt; 2 may be considered for management in a stroke unit without critical care capabilities