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Candidate predictors were selected using all-subsets modelling for each time window. Model performance was assessed overall and in predefined subgroups. Results: Among 1821 patients, ECL-24 h was applied in 355 (19.5%) and an additional 102 had ECL by 72 h, yielding an overall ECL rate of 25.1%. Strongest predictors of ECL-24 h were age, prior anticoagulant use, baseline NIHSS, ICH volume and intraventricular haemorrhage (AUC 0.88). Predictors of ECL-72 h were age, prior anticoagulant use, pre-stroke mRS, baseline NIHSS and early neurological deterioration within 72 h (AUC 0.90). Across subgroups, AUCs ranged from 0.85 to 0.90, with lower performance in infratentorial ICH for ECL-72 h and in telestroke centres. Among ECL-24 h patients, 39 (11%) achieved 3-month favourable functional outcome, whereas no patients with ECL-72 h achieved this outcome. Conclusion: Early care limitation after ICH is frequent and its determinants differ by timing. In our study, very early decisions rely mainly on the static severity at admission, whereas later decisions incorporate neurological deterioration and appear to better align with prognosis. These findings support deferring ECL decisions until clinical evolution can be observed. 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Destination: toc.chapter Children: Item: Title: Introduction Destination: section.41.1.1 Item: Title: Patients and methods Destination: section.42.1.2 Item: Title: Results Destination: section.47.1.3 Item: Title: Discussion Destination: section.56.1.4 Item: Title: Acknowledgements Destination: section.57.1.5 Item: Title: Author contributions Destination: section.58.1.6 Item: Title: Supplementary material Destination: section.59.1.7 Item: Title: Conflicts of interest Destination: section.60.1.8 Item: Title: Funding Destination: section.61.1.9 Item: Title: Data availability Destination: section.62.1.10 Item: Title: Ethics approval Destination: section.63.1.11 Item: Title: Consent to participate Destination: section.64.1.12 Item: Title: Informed consent Destination: section.65.1.13 Item: Title: Author agreement Destination: section.66.1.14 Item: Title: Authorship Destination: section.67.1.15 Item: Title: Originality and prior publication Destination: section.68.1.16 Info: Title: Early care limitation after ICH in a population-based study: what drives clinicians’ decisions? Author: Subject: DOI: 10.1093/esj/aakag028, European Stroke Journal, 11, 4, 6 4 2026. Abstract: Introduction: Early care limitation (ECL) after ICH is increasingly recognised, but population-based data on time-dependent determinants remain scarce. We aimed to identify influencing factors of ECL within 72 h from admission and explore differences by sex, haematoma location and stroke-centre type. Patients and methods: Prospective population-based study of consecutively recruited adults with spontaneous ICH and pre-stroke mRS 0 3, admitted within the first 24 h to any hospital of the Catalan Stroke Network (HIC-CAT registry, 2020-2022). Early care limitation was recorded at 24 h (ECL-24 h) and 72 h (ECL-72 h). Candidate predictors were selected using all-subsets modelling for each time window. Model performance was assessed overall and in predefined subgroups. Results: Among 1821 patients, ECL-24 h was applied in 355 (19.5%) and an additional 102 had ECL by 72 h, yielding an overall ECL rate of 25.1%. Strongest predictors of ECL-24 h were age, prior anticoagulant use, baseline NIHSS, ICH volume and intraventricular haemorrhage (AUC 0.88). Predictors of ECL-72 h were age, prior anticoagulant use, pre-stroke mRS, baseline NIHSS and early neurological deterioration within 72 h (AUC 0.90). Across subgroups, AUCs ranged from 0.85 to 0.90, with lower performance in infratentorial ICH for ECL-72 h and in telestroke centres. Among ECL-24 h patients, 39 (11%) achieved 3-month favourable functional outcome, whereas no patients with ECL-72 h achieved this outcome. Conclusion: Early care limitation after ICH is frequent and its determinants differ by timing. In our study, very early decisions rely mainly on the static severity at admission, whereas later decisions incorporate neurological deterioration and appear to better align with prognosis. These findings support deferring ECL decisions until clinical evolution can be observed. Keywords: Creator: LaTeX with hyperref package Producer: Acrobat Distiller 23.0 (Windows); modified using iTextSharp.LGPLv2.Core 3.7.4.0 CreationDate: Sun Apr 05 16:33:18 CEST 2026 ModDate: Mon May 18 13:42:25 CEST 2026 ID: 0xfa2f1328a339b19fcbc3fc76c35622e5, 0xffa8143d02dcb19d4a12be7d9711c746 Filters: FilterPipeline: FlateDecode FilterPipeline: DCTDecode Images: Image: NisoImageMetadata: FormatName: image/jpg CompressionScheme: JPEG ImageWidth: 253 ImageHeight: 180 ColorSpace: CMYK BitsPerSample: 8 BitsPerSampleUnit: integer Image: NisoImageMetadata: FormatName: image/png ImageWidth: 10 ImageHeight: 20 ColorSpace: RGB BitsPerSample: 8 BitsPerSampleUnit: integer Filter: FlateDecode Image: NisoImageMetadata: FormatName: image/jpg CompressionScheme: JPEG ImageWidth: 423 ImageHeight: 119 ColorSpace: RGB BitsPerSample: 8 BitsPerSampleUnit: integer Image: NisoImageMetadata: FormatName: image/jpg CompressionScheme: JPEG ImageWidth: 21 ImageHeight: 17 ColorSpace: RGB BitsPerSample: 8 BitsPerSampleUnit: integer Image: NisoImageMetadata: FormatName: image/jpg CompressionScheme: JPEG ImageWidth: 21 ImageHeight: 21 ColorSpace: RGB BitsPerSample: 8 BitsPerSampleUnit: integer Image: NisoImageMetadata: FormatName: image/jpg CompressionScheme: JPEG ImageWidth: 1000 ImageHeight: 841 ColorSpace: RGB BitsPerSample: 8 BitsPerSampleUnit: integer Image: NisoImageMetadata: FormatName: image/jpg CompressionScheme: JPEG ImageWidth: 1600 ImageHeight: 2354 ColorSpace: RGB BitsPerSample: 8 BitsPerSampleUnit: integer Fonts: Type1: Font: BaseFont: CJNOGH+MTSYN FontSubset: true FirstChar: 2 LastChar: 215 FontDescriptor: FontName: CJNOGH+MTSYN Flags: Symbolic FontBBox: 0, -954, 1043, 900 FontFile3: true EncodingDictionary: Differences: true ToUnicode: true Font: BaseFont: CJPBDH+SFRM1000 FontSubset: true FirstChar: 169 LastChar: 169 FontDescriptor: FontName: CJPBDH+SFRM1000 Flags: Serif, Symbolic FontBBox: -189, -321, 1456, 937 FontFile3: true EncodingDictionary: Differences: true ToUnicode: true Font: BaseFont: CJNHMK+SourceSansPro-Semibold FontSubset: true FirstChar: 2 LastChar: 243 FontDescriptor: FontName: CJNHMK+SourceSansPro-Semibold Flags: Symbolic FontBBox: -46, -217, 811, 881 FontFile3: true EncodingDictionary: Differences: true ToUnicode: true Font: BaseFont: CJNHML+SourceSansPro-Light FontSubset: true FirstChar: 40 LastChar: 243 FontDescriptor: FontName: CJNHML+SourceSansPro-Light Flags: Symbolic FontBBox: -33, -231, 763, 754 FontFile3: true EncodingDictionary: Differences: true ToUnicode: true Font: BaseFont: CJNIJH+SourceSansPro-It FontSubset: true FirstChar: 45 LastChar: 121 FontDescriptor: FontName: CJNIJH+SourceSansPro-It Flags: Symbolic, Italic FontBBox: -211, -284, 1106, 969 FontFile3: true EncodingDictionary: Differences: true ToUnicode: true Font: BaseFont: CJOBPE+SourceSansPro-BoldIt FontSubset: true FirstChar: 80 LastChar: 110 FontDescriptor: FontName: CJOBPE+SourceSansPro-BoldIt Flags: Symbolic, Italic FontBBox: -215, -297, 1167, 1007 FontFile3: true EncodingDictionary: Differences: true ToUnicode: true Font: BaseFont: CJNIKI+SourceSansPro-Regular FontSubset: true FirstChar: 2 LastChar: 246 FontDescriptor: FontName: CJNIKI+SourceSansPro-Regular Flags: Symbolic FontBBox: -40, -224, 796, 867 FontFile3: true EncodingDictionary: Differences: true ToUnicode: true Font: BaseFont: CJNIKJ+SourceSansPro-Bold FontSubset: true FirstChar: 2 LastChar: 144 FontDescriptor: FontName: CJNIKJ+SourceSansPro-Bold Flags: Symbolic FontBBox: -51, -211, 832, 735 FontFile3: true EncodingDictionary: Differences: true ToUnicode: true Font: BaseFont: CJNOMG+MTMI FontSubset: true FirstChar: 2 LastChar: 62 FontDescriptor: FontName: CJNOMG+MTMI Flags: Serif, Symbolic, Italic FontBBox: 0, -213, 987, 680 FontFile3: true EncodingDictionary: Differences: true ToUnicode: true Font: BaseFont: CJNLFJ+SourceSansPro-SemiboldIt FontSubset: true FirstChar: 58 LastChar: 117 FontDescriptor: FontName: CJNLFJ+SourceSansPro-SemiboldIt Flags: Symbolic, Italic FontBBox: -213, -291, 1137, 988 FontFile3: true EncodingDictionary: Differences: true ToUnicode: true TrueType: Font: BaseFont: RZVMCI+ArialMT FontSubset: true FirstChar: 32 LastChar: 121 FontDescriptor: FontName: RZVMCI+ArialMT Flags: Nonsymbolic FontBBox: -664, -324, 2000, 1039 FontFile2: true Encoding: WinAnsiEncoding Font: BaseFont: AXESPD+ArialMT FontSubset: true FirstChar: 32 LastChar: 32 FontDescriptor: FontName: AXESPD+ArialMT Flags: Nonsymbolic FontBBox: -664, -324, 2000, 1039 FontFile2: true Encoding: WinAnsiEncoding XMP: application/pdf Early care limitation after ICH in a population-based study: what drives clinicians’ decisions? Camps-Renom Pol ConceptualizationFormal analysisInvestigationMethodologySoftwareValidationVisualizationWriting - review & editing Martí-Fàbregas Joan ConceptualizationData curationFunding acquisitionInvestigationProject administrationResourcesSupervisionWriting - review & editing Guasch-Jiménez Marina InvestigationVisualizationWriting - review & editing Ezcurra-Díaz Garbiñe VisualizationWriting - review & editing Fernández-Vidal Joan Miquel VisualizationWriting - review & editing Prats-Sanchez Luis InvestigationVisualizationWriting - review & editing Martínez-Domeño Alejandro InvestigationResourcesWriting - review & editing Ossa Natalia Pérez de la InvestigationProject administrationResourcesVisualizationWriting - review & editing Ramos-Pachón Anna ConceptualizationData curationFormal analysisInvestigationMethodologySupervisionValidationVisualizationWriting - original draftWriting - review & editing DOI: 10.1093/esj/aakag028, European Stroke Journal, 11, 4, 6 4 2026. Abstract: Introduction: Early care limitation (ECL) after ICH is increasingly recognised, but population-based data on time-dependent determinants remain scarce. We aimed to identify influencing factors of ECL within 72 h from admission and explore differences by sex, haematoma location and stroke-centre type. Patients and methods: Prospective population-based study of consecutively recruited adults with spontaneous ICH and pre-stroke mRS 0–3, admitted within the first 24 h to any hospital of the Catalan Stroke Network (HIC-CAT registry, 2020-2022). Early care limitation was recorded at 24 h (ECL-24 h) and 72 h (ECL-72 h). Candidate predictors were selected using all-subsets modelling for each time window. Model performance was assessed overall and in predefined subgroups. Results: Among 1821 patients, ECL-24 h was applied in 355 (19.5%) and an additional 102 had ECL by 72 h, yielding an overall ECL rate of 25.1%. Strongest predictors of ECL-24 h were age, prior anticoagulant use, baseline NIHSS, ICH volume and intraventricular haemorrhage (AUC 0.88). Predictors of ECL-72 h were age, prior anticoagulant use, pre-stroke mRS, baseline NIHSS and early neurological deterioration within 72 h (AUC 0.90). Across subgroups, AUCs ranged from 0.85 to 0.90, with lower performance in infratentorial ICH for ECL-72 h and in telestroke centres. Among ECL-24 h patients, 39 (11%) achieved 3-month favourable functional outcome, whereas no patients with ECL-72 h achieved this outcome. Conclusion: Early care limitation after ICH is frequent and its determinants differ by timing. In our study, very early decisions rely mainly on the static severity at admission, whereas later decisions incorporate neurological deterioration and appear to better align with prognosis. These findings support deferring ECL decisions until clinical evolution can be observed. decision-making early care limitation ICH life support care patient care management prognosis self-fulfilling prophecies stroke stroke care networks withdrawal of treatment © The Author(s) 2026. Published by Oxford University Press on behalf of the European Stroke Organisation. 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