Prognostic Value of Clinical Scores and Cardiac Troponin I in Patients with Spontaneous Intracerebral Hemorrhage

Background/Objectives: Spontaneous intracerebral hemorrhage (sICH) is a severe form of stroke associated with high mortality and disability rates, and reliable prognostic markers remain limited. This study aimed to evaluate the prognostic value of ICH score components, the National Institutes of Health Stroke Scale (NIHSS), and high-sensitivity cardiac troponin I (hs-cTnI) for predicting 30-day mortality in patients with sICH. Methods: In this prospective observational cohort study, 100 consecutive patients with neuroradiologically confirmed sICH were enrolled. Demographic data, clinical parameters, neuroimaging findings, and serum hs-cTnI levels were collected on admission. Subsequently, the ICH score, its individual components, and the NIHSS score were assessed. Results: Patients who died had significantly higher ICH and NIHSS scores, were older, had lower Glasgow Coma Scale (GCS) scores, larger hema-toma volumes, more frequent intraventricular hemorrhage (IVH), and elevated hs-cTnI levels compared with survivors. Serum hs-cTnI concentrations significantly correlated with ICH and NIHSS scores, lower GCS scores, larger hematoma volumes, and the presence of IVH. On univariate logistic regression, ICH score, NIHSS, and hs-cTnI were independent predictors of mortality, whereas multivariate analysis identified GCS score, hematoma volume, and IVH as significant determinants of fatal outcome. Conclusions: ICH score and its components, NIHSS, and serum hs-cTnI levels are valuable prognostic tools in patients with sICH. These markers may help clinicians identify high-risk pa-tients, optimize monitoring, and guide therapeutic decisions. Nevertheless, larger multicenter studies are warranted to further clarify their clinical implications in sICH management.