Hematoma, Perihematomal Edema, and Total Lesion Predict Outcome in Patients With Intracerebral Hemorrhage

Abstract

Background

The present study aimed to evaluate the predictive abilities of hematoma volume, perihematomal edema (PHE) volume, and total lesion (hematoma + PHE) volume for poor outcome in patients with intracerebral hemorrhage (ICH).

Methods

Patients admitted to our department between January 2015 and March 2023 were retrospectively enrolled according to the inclusion criteria and exclusion criteria. Demographic characteristics, clinical information, laboratory examinations, and imaging data were collected.

Results

We included 510 patients with initial computerized tomography (CT) scan (342 [67.1%] male, median age = 62 years); 142 patients had CT scans at admission and 72 h post ICH, and 350 patients had CT scans at admission and 5–9 days after onset. Multivariate logistic regression analysis revealed that absolute hematoma, absolute PHE, and absolute total lesion at admission; absolute hematoma and absolute total lesion at 72 h after onset; absolute hematoma, absolute PHE, and absolute total lesion at 5–9 days post ICH were independently related to poor outcome (p < 0.05). Furthermore, receiver operating characteristic curves demonstrated that the total volume of hematoma and PHE at 5–9 days post ICH was a better indicator to predict poor outcome, compared to other risk factors in patients with ICH (area under curve = 0.778, 95%CI: 0.729–0.826).

Conclusion

The total volume of hematoma and PHE at 5–9 days after onset had the highest ability in predicting poor outcome in patients with ICH.