{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T06:54:30Z","timestamp":1791269670140,"version":"4.1.0"},"reference-count":19,"publisher":"Oxford University Press (OUP)","issue":"9","license":[{"start":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T00:00:00Z","timestamp":1788998400000},"content-version":"vor","delay-in-days":9,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,9,5]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Prognostic scores are routinely applied after spontaneous intracerebral haemorrhage (ICH) to inform clinical decision-making and stratify risk; however, direct comparative validation in contemporary, multinational real-world cohorts remains scarce.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>To compare the discriminative performance of the ICH Score, max-ICH and ICH Functional Outcome Score (ICH-FOS) for discharge outcomes after spontaneous intracerebral haemorrhage in a large contemporary multinational cohort from the International Registry of Stroke Care Quality (RES-Q).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We analysed consecutive adults with spontaneous ICH recorded in RES-Q between September 2024 and April 2025. Discharge outcomes were defined according to the modified Rankin Scale (mRS): mortality (mRS\u00a0=\u00a06), unfavourable functional outcome (mRS\u00a0\u2265\u00a04) and composite poor outcome (mRS 5-6). Discrimination was assessed using receiver operating characteristic curves and area under the curves (AUCs) with 95% confidence intervals. Areas under the curve were compared in the same complete-case cohort using global tests and pairwise DeLong contrasts. Score distributions were characterised descriptively to explore differences in granularity.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The complete-case cohort comprised 8450 patients from 56 countries. Median age was 63 (20) years, and 62% were male. Median National Institutes of Health Stroke Scale was 11 (12), Glasgow Coma Scale 14 (4) and median haematoma volume 16 (27) mL. Supratentorial ICH occurred in 82.1%, intraventricular haemorrhage in 31.5% and pre-admission oral anticoagulant use in 4.5%. Discharge mortality was 15.1% and favourable outcome (mRS 0-3) 56.6%. Discrimination was good for mortality (AUC 0.82 [0.81-0.83] for ICH Score, 0.81 [0.79-0.82] for max-ICH, 0.84 [0.83-0.86] for ICH-FOS; global P\u00a0&amp;lt;\u00a0.0001). For unfavourable outcome (mRS\u00a0\u2265\u00a04), AUCs were 0.77 (0.76-0.78), 0.81 (0.81-0.82) and 0.84 (0.83-0.85), respectively (P\u00a0&amp;lt;\u00a0.0001). For composite poor outcome (mRS 5-6), AUCs were 0.83 (0.82-0.84), 0.84 (0.83-0.85) and 0.87 (0.86-0.88) (P\u00a0&amp;lt;\u00a0.0001).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In this large, contemporary, multinational registry cohort, all 3 prognostic scores demonstrated acceptable-to-excellent discriminative ability for discharge outcomes following spontaneous ICH. ICH Functional Outcome Score consistently achieved the highest discriminative performance across all endpoints, whereas max-ICH provided a pragmatic and robust alternative based on routinely available clinical variables.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/esj\/aakag105","type":"journal-article","created":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T04:31:39Z","timestamp":1789014699000},"source":"Crossref","is-referenced-by-count":0,"title":["Comparative external validation of ICH prognostic scores for discharge outcomes in the RES-Q multinational quality registry"],"prefix":"10.1093","volume":"11","author":[{"given":"Ana Cl\u00e1udia","family":"de Souza","sequence":"first","affiliation":[{"name":"Department of Neurology and Neurosurgery, Hospital Moinhos de Vento , Porto Alegre ,","place":["Brazil"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Geraldo","family":"Neto","sequence":"additional","affiliation":[{"name":"Stroke Research Program, International Clinical Research Center, St Anne\u2019s University Hospital , Brno ,","place":["Czech Republic"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nguyen Huy","family":"Thang","sequence":"additional","affiliation":[{"name":"The People\u2019s 115 Hospital Pham Ngoc Thach University of Medicine , Ho Chi Minh ,","place":["Vietnam"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nijasri C","family":"Suwanwela","sequence":"additional","affiliation":[{"name":"Division of Neurology, Department of Medicine, Faculty of Medicine, Chulalongkorn University and Chulalongkorn Stroke Center, King Chulalongkorn Memorial Hospital , Bangkok ,","place":["Thailand"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adin","family":"Nulkhasanah","sequence":"additional","affiliation":[{"name":"Clinical Research Unit, National Brain Center Hospital Mahar Mardjono Jakarta , Jakarta ,","place":["Indonesia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Epifania","family":"Collantes","sequence":"additional","affiliation":[{"name":"University of the Philippines Manila College of Medicine, Philippine General Hospital , Manila ,","place":["Philippines"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sheila Ouriques","family":"Martins","sequence":"additional","affiliation":[{"name":"Department of Neurology and Neurosurgery, Hospital Moinhos de Vento , Porto Alegre ,","place":["Brazil"]},{"name":"Department of Neurology, Hospital de Cl\u00ednicas de Porto Alegre, Universidade Federal do Rio Grande do Sul , Porto Alegre ,","place":["Brazil"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sergii","family":"Moskovko","sequence":"additional","affiliation":[{"name":"Neurology Department, Vinnitsa National Pirogov Memorial Medical University , Vinnitsa ,","place":["Ukraine"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mario A","family":"Munoz-Collazos","sequence":"additional","affiliation":[{"name":"Department of Neurology, Marly Clinic , Bogot\u00e1 ,","place":["Colombia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Louis","family":"Kroon","sequence":"additional","affiliation":[{"name":"Department of Neurology, Steve Biko Academic Hospital, University of Pretoria ,","place":["South Africa"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeyaraj","family":"Pandian","sequence":"additional","affiliation":[{"name":"Department of Neurology, Christian Medical College , Ludhiana, Punjab 141008 ,","place":["India"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adam","family":"Kobayashi","sequence":"additional","affiliation":[{"name":"Department of Neurology, Stroke and Vascular Diseases Institute of Medical Sciences Faculty of Medicine\u2014Collegium Medicum Cardinal Stefan Wyszynski University in Warsaw , Warsaw ,","place":["Poland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zuzana","family":"Gdovinov\u00e1","sequence":"additional","affiliation":[{"name":"Department of Neurology, P. J. Safarik University Kosice, Faculty of Medicine and University Hospital L. Pasteur , Kosice ,","place":["Slovak Republic"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Natalia","family":"Ciobanu","sequence":"additional","affiliation":[{"name":"Institute of Emergency Medicine, University of Medicine and Pharmacy Nicolae Testemitanu , Chisinau ,","place":["Republic of Moldova"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8613-2909","authenticated-orcid":false,"given":"Francisco","family":"Moniche","sequence":"additional","affiliation":[{"name":"Department of Neurology, Stroke Unit, Instituto de Biomedicina de Sevilla (IBiS), Hospital Universitario Virgen Del Roc\u00edo\/CSIC\/Universidad de Sevilla , Seville ,","place":["Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cristina","family":"Tiu","sequence":"additional","affiliation":[{"name":"\u201cCarol Davila\u201d University of Medicine and Pharmacy , Bucharest ,","place":["Romania"]},{"name":"University Hospital Bucharest , Bucharest ,","place":["Romania"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rupal","family":"Sedani","sequence":"additional","affiliation":[{"name":"World Stroke Organization, Geneva, Switzerland and Health Management Institute , Brno ,","place":["Czech Republic"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7458-5166","authenticated-orcid":false,"given":"Robert","family":"Mikul\u00edk","sequence":"additional","affiliation":[{"name":"Health Management Institute , Brno ,","place":["Czech Republic"]},{"name":"International Clinical Research Centre, St. Anne's University Hospital , Brno ,","place":["Czech Republic"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P N","family":"Sylaja","sequence":"additional","affiliation":[{"name":"Comprehensive Stroke Care Program, Sree Chitra Tirunal Institute for Medical Sciences and Technology , Thiruvananthapuram, Kerala ,","place":["India"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,9,10]]},"reference":[{"key":"2026100602311772100_ref1","doi-asserted-by":"publisher","first-page":"795","DOI":"10.1016\/S1474-4422(21)00252-0","article-title":"Global, regional, and national burden of stroke and its risk factors, 1990-2019: a systematic analysis for the global burden of disease study 2019","volume":"20","author":"GBD 2019 Stroke Collaborators","year":"2021","journal-title":"Lancet Neurol"},{"key":"2026100602311772100_ref2","doi-asserted-by":"publisher","first-page":"1160","DOI":"10.1016\/S1474-4422(23)00277-6","article-title":"Pragmatic solutions to reduce the global burden of stroke: a world stroke organization-lancet neurology commission","volume":"22","author":"Feigin","year":"2023","journal-title":"Lancet Neurol"},{"key":"2026100602311772100_ref3","doi-asserted-by":"publisher","first-page":"e282","DOI":"10.1161\/STR.0000000000000407","article-title":"2022 guideline for the management of patients with spontaneous intracerebral hemorrhage: a guideline from the American Heart Association\/American Stroke Association","volume":"53","author":"Greenberg","year":"2022","journal-title":"Stroke"},{"key":"2026100602311772100_ref4","doi-asserted-by":"publisher","first-page":"494","DOI":"10.1161\/STROKEAHA.123.043033","article-title":"Code ICH: a call to action","volume":"55","author":"Li","year":"2024","journal-title":"Stroke."},{"key":"2026100602311772100_ref5","doi-asserted-by":"publisher","first-page":"27","DOI":"10.1016\/S0140-6736(23)00806-1","article-title":"The third intensive care bundle with blood pressure reduction in acute cerebral haemorrhage trial (INTERACT3): an international, stepped wedge cluster randomised controlled trial","volume":"402","author":"Ma","year":"2023","journal-title":"Lancet"},{"key":"2026100602311772100_ref6","doi-asserted-by":"publisher","first-page":"773","DOI":"10.1056\/NEJMc2407378","article-title":"Andexanet for factor Xa inhibitor-associated acute intracerebral hemorrhage","volume":"391","author":"Wong","year":"2024","journal-title":"N Engl J Med"},{"key":"2026100602311772100_ref7","doi-asserted-by":"publisher","first-page":"1277","DOI":"10.1056\/NEJMoa2308440","article-title":"ENRICH trial investigators; ENRICH trial investigators. 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