The Role of Erythrocyte Sedimentation Rate as a Prognostic Factor in Intracerebral Hemorrhage

Background: Intracerebral hemorrhage (ICH) is a severe type of stroke with high mortality and long-term disability rates. Early identification of patients at high risk of poor outcomes is crucial. Erythrocyte sedimentation rate (ESR), a nonspecific marker of inflammation, may serve as a prognostic indicator in ICH patients. Methods: This retrospective cohort study analyzed 82 ICH patients from December 2021 to February 2024. Patients were divided into high ESR (≥ 20 mm/h) and normal ESR (< 20 mm/h) groups. Demographic, clinical, and laboratory data were collected, and outcomes were assessed using the modified Rankin Scale (mRS) at 6 months post-ICH. Logistic regression analyzed the association between ESR levels and outcomes. Results: Elevated ESR was observed in 35 patients (42.7%). Mortality rate at 6 months was significantly higher in the elevated ESR group (20% vs. 8.5%, P = 0.03), with elevated ESR being an independent predictor of mortality (odds ratio (OR) = 2.5). Functional impairment (mRS > 3) was also higher in the elevated ESR group (65.7% vs. 34%, P = 0.002), with elevated ESR independently associated with functional impairment (OR = 3.1). Conclusions: Elevated ESR at admission is an independent predictor of mortality and functional impairment in ICH patients. ESR can aid in risk stratification and guide clinical decision-making, emphasizing the role of inflammation in ICH.