医学
优势比
置信区间
脑出血
格拉斯哥昏迷指数
血肿
逻辑回归
计算机断层血管造影
放射科
血管造影
内科学
核医学
外科
作者
Andrea Morotti,Qi Li,Jawed Nawabi,Giorgio Busto,Federico Mazzacane,Anna Cavallini,Ashkan Shoamanesh,Mauro Morassi,Frieder Schlunk,Laura Piccolo,Giacomo Urbinati,Debora Pezzini,Maurizio Paciaroni,Enrico Fainardi,Ilaria Casetta,Alessandro Padovani,Andrea Zini
标识
DOI:10.1177/23969873241247436
摘要
Severe hematoma expansion (sHE) has the strongest impact on intracerebral hemorrhage (ICH) outcome. We investigated the predictors of sHE.Retrospective analysis of ICH patients admitted at nine sites in Italy, Germany, China, and Canada. The following imaging features were analyzed: non-contrast CT (NCCT) hypodensities, heterogeneous density, blend sign, irregular shape, and CT angiography (CTA) spot sign. The outcome of interest was sHE, defined as volume increase >66% and/or >12.5 from baseline to follow-up NCCT. Predictors of sHE were explored with logistic regression.A total of 1472 patients were included (median age 73, 56.6% males) of whom 223 (15.2%) had sHE. Age (odds ratio (OR) per year, 95% confidence interval (CI), 1.02 (1.01-1.04)), Anticoagulant treatment (OR 3.00, 95% CI 2.09-4.31), Glasgow Coma Scale (OR 0.93, 95% CI 0.89-0.98), time from onset/last known well to imaging, (OR per h 0.96, 95% CI 0.93-0.99), and baseline ICH volume, (OR per mL 1.02, 95% CI 1.02-1.03) were independently associated with sHE. Ultra-early hematoma growth (baseline volume/baseline imaging time) was also a predictor of sHE (OR per mL/h 1.01, 95% CI 1.00-1.02). All NCCT and CTA imaging markers were also predictors of sHE. Amongst imaging features NCCT hypodensities had the highest sensitivity (0.79) whereas the CTA spot sign had the highest positive predictive value (0.51).sHE is common in the natural history of ICH and can be predicted with few clinical and imaging variables. These findings might inform clinical practice and future trials targeting active bleeding in ICH.
科研通智能强力驱动
Strongly Powered by AbleSci AI