What Are We Measuring?

Subarachnoid hemorrhage (SAH) and intracerebral hemorrhage (ICH) are medical emergencies requiring rapid diagnosis and assessment. Early deterioration is common in the first few hours after onset, and associated with increased mortality rates of greater than 75% compared to 30-day mortality rates of 35%-52%. More than half of all deaths from these conditions occur within the first two days of onset.

According to the American Heart Association/American Stroke Association and the Joint Commission, the severity of SAHs should be documented with the Hunt and Hess Scale, and the severity of ICHs should be documented with ICH score to capture the clinical state of the patient. The severity of initial neurological injury should be determined and documented upon arrival to MGH because it is a useful predictor of outcome and helpful in planning future care with family and physicians.

This Joint Commission national quality measure reports the percentage of SAH and ICH stroke patients for whom a severity measurement was performed prior to surgical intervention.

Severity Measurement for Subarachnoid Hemorrhage and Intracerebral Hemorrhage

Higher scores are better