Hunt and Hess classification of subarachnoid hemorrhage
The Hunt and Hess classification enables classification of the severity of a subarachnoid hemorrhage and predicts its mortality.
Research authors: Hunt WE, Hess RM
Version: 1.16
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  • Traumatology
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Hunt & Hess risk score: points

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Model performance:
  • In a study bij Hunt & Huss (1968) including 275 cases, the mortality was 20% for patients admitted to the hospital at grade I or II, whereas in patients who reached the operating room for any procedure whatever at grade I or II, it was 14%. The difference in mortality was due to a number of instances of early fatal rebleeding. 
  • Worldwide, different scales are used to assess the clinical condition on admission after aneurysmal subarachnoid hemorrhage. In addition to the prognostic value, the inter-rater variability should be taken into account when deciding which scale preferably should be used.
  • In a validation study by Degen et al (2011) including 50 subarachnoid hemorrhage patients, the Hunt and Hess scale showed moderate interobserver agreement (weighted kappa value: 0.48; 95% CI, 0.36–0.59). The World Federation of Neurological Surgeons and the Prognosis on Admission of Aneurysmal Subarachnoid Hemorrhage scales both showed good interobserver agreement (0.64 and 0.60 respectively) with overlapping CI. 

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This model is provided for educational, training and information purposes. It must not be used to support medical decision making, or to provide medical or diagnostic services. Read our full disclaimer.

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