A Study On Prognostic Factors And Grading Scales Of Spontaneous Intracerebral Hemorrhage

Object:Spontaneous intracerebral hemorrhage(SICH)is the type of stroke with the highest mortality and disability rate.Accurate prediction is conducive to the understanding and communication between doctors and patients on the condition,and can also select the key patients for relevant support treatment and follow-up rehabilitation exercise.Original ICH score(oICH),Modified ICH score(mICH),Essen ICH score and The max-ICH score(max-ICH score)are commonly used rating scales to predict the outcome of intracerebral hemorrhage.In this study,in the case of acute onset of cerebral hemorrhage and admission,combined with the basic examination of patients,the function of patients within 3 months of the onset was classified as the outcome,and the risk factors for predicting adverse outcomes were screened.In addition,by comparing the differences in the predictive ability of the above three rating scales,we can judge their clinical application value.Method:This study selected 226 patients who came to our hospital for treatment within 24 hours after onset of spontaneous intracerebral hemorrhage.The patients’ basic information,personal history and hematoma imaging characteristics were recorded.The functional outcome of the patients at 3 months after the onset of cerebral hemorrhage was recorded.According to the mRS score,the patients were divided into the group with good prognosis(mRS≤2)and the group with poor prognosis(mRS≥3).The factors with statistical significance in univariate analysis were further analyzed by binary logistic regression model to screen the risk factors that predicted adverse outcomes.To compare the differences of the scales,the area under the curve(AUC)and other parameters of each rating scale were calculated by receiver operating characteristic curve(ROC).Results:Single factor statistical analysis is carried out on the two groups,according to the results,between the two groups in age,hospital hematoma volume of hematoma broken hospital blood sugar into the ventricle systolic blood pressure(SBP)red blood cell count(RBC),hemoglobin(HGB),mean corpuscular volume(MCV),red blood cell distribution width(RDW)white blood cell count(WBC),neutrophil count(NE#),mean platelet volume(MPV),platelet distribution width(PDW),GCS,NIHSS,surgery therapy and pulmonary infection difference are statistically significant(P<0.05).Further binary logistic regression analysis shows that age,hematoma volume,RDW and NIHSS are the predictors of 3-month poor outcome after the onset of ICH.In the prediction of 3-month mortality of cerebral hemorrhage,the AUC of mICH(AUC 0.890,95%CI 0.842-0.928)Essen(AUC 0.916,95%CI 0.872-0.949)and max-ICH(AUC 0.877,95%CI 0.827-0.917)are compared with the oICH(AUC 0.889,95%CI 0.841-0.927)scale,respectively,and the results show no statistically significant difference(P>0.05).When predicting the adverse outcome of cerebral hemorrhage at 3 months,there is no significant statistical difference in AUC between mICH(AUC 0.916,95%CI 0.872-0.949),max-ICH(AUC 0.889,95%CI 0.841-0.927)and oICH(AUC 0.903,95%CI 0.856-0.938)scales,while there is significant statistical difference in AUC between Essen(AUC 0.953,95%CI 0.917-0.977)scale and oICH scale(P=0.022).Conclusion:In this study,both age hematoma volume RDW and NIHSS are the predictors of 3-month poor outcome after intracerebral hemorrhage.The oICH,mICH,Essen and max-ICH scales all accurately predicte the 3-month mortality and poor outcome of ICH patients.Among them,the Essen scale is more accurate than the oICH scale in predicting the 3-month poor outcome of ICH patients.The clinical applicability of the grading scales needs to be further verified by multi-center studies.