Optimal intraventricular hemorrhage volume cutoff for predicting poor outcome in patients with intracerebral hemorrhage

作者全名：Deng, Lan; Zhang, Jiang-Tao; Lv, Xin-Ni; Li, Zuo-Qiao; Chen, Chu; Hu, Xiao; Yin, Hao; Yang, Tian-Nan; Zhang, Zhe-Ha; Li, Qi

作者地址：[Deng, Lan; Lv, Xin-Ni; Li, Zuo-Qiao; Chen, Chu; Hu, Xiao; Yin, Hao; Yang, Tian-Nan; Zhang, Zhe-Ha] Chongqing Med Univ, Affiliated Hosp 1, Dept Neurol, Chongqing 400016, Peoples R China; [Zhang, Jiang-Tao] Chengde Cent Hosp, Dept Neurol, Chengde 067000, Hebei, Peoples R China; [Li, Qi] Anhui Med Univ, Affiliated Hosp 2, Dept Neurol, Hefei 230601, Anhui, Peoples R China

通信作者：Li, Q (通讯作者)，Anhui Med Univ, Affiliated Hosp 2, Dept Neurol, Hefei 230601, Anhui, Peoples R China.

来源：JOURNAL OF STROKE & CEREBROVASCULAR DISEASES

ESI学科分类：NEUROSCIENCE & BEHAVIOR

WOS号：WOS:001219155200001

JCR分区：Q3

影响因子：2

年份：2024

卷号：33

期号：6

开始页：　

结束页：　

文献类型：Article

关键词：Intracerebral hemorrhage; Intraventricular hemorrhage; Volume; Cutoff; outcome

摘要：Background and objectives: The prognosis of patients with spontaneous intracerebral hemorrhage (ICH) is often influenced by hematoma volume, a well-established predictor of poor outcome. However, the optimal intraventricular hemorrhage (IVH) volume cutoff for predicting poor outcome remains unknown. Methods: We analyzed 313 patients with spontaneous ICH not undergoing evacuation, including 7 cases with external ventricular drainage (EVD). These patients underwent a baseline CT scan, followed by a 24-hour CT scan for measurement of both hematoma and IVH volume. We defined hematoma growth as hematoma growth > 33 % or 6 mL at follow-up CT, and poor outcome as modified Rankin Scale score >= 3 at three months. Cutoffs with optimal sensitivity and specificity for predicting poor outcome were identified using receiver operating curves. Results: The receiver operating characteristic analysis identified 6 mL as the optimal cutoff for predicting poor outcome. IVH volume> 6 mL was observed in 53 (16.9 %) of 313 patients. Patients with IVH volume>6 mL were more likely to be older and had higher NIHSS score and lower GCS score than those without. IVH volume>6 mL (adjusted OR 2.43, 95 % CI 1.13-5.30; P = 0.026) was found to be an independent predictor of poor clinical outcome at three months in multivariable regression analysis. Conclusions: Optimal IVH volume cutoff represents a powerful tool for improving the prediction of poor outcome in patients with ICH, particularly in the absence of clot evacuation or common use of EVD. Small amounts of intraventricular blood are not independently associated with poor outcome in patients with intracerebral hemorrhage. The utilization of optimal IVH volume cutoffs may improve the clinical trial design by targeting ICH patients that will obtain maximal benefit from therapies.

基金机构：National Natural Science Foundation of China [82071337]; Chongqing Innovation Support Program for Returned Overseas Chinese Scholars [cx2020002]; Chongqing Science Fund for Distinguished Young Scholars [2022zhyx-C38]; Research Fund of Anhui Institute of translational medicine; First Affiliated Hospital of Chongqing Medical University PhD Innovation Program [cstc2021jcyj-jqX0029]; [CYYY-BSYJSCXXM-202206]

基金资助正文：This study was supported by the National Natural Science Foundation of China (Grant No.82071337), the Chongqing Innovation Support Program for Returned Overseas Chinese Scholars (Grant No. cx2020002), the Chongqing Science Fund for Distinguished Young Scholars (Grant No.cstc2021jcyj-jqX0029), Research Fund of Anhui Institute of translational medicine (Grant No.2022zhyx-C38), and the First Affiliated Hospital of Chongqing Medical University PhD Innovation Program (Grant No. CYYY-BSYJSCXXM-202206).