超早期血肿生长预测自发性脑出血后胃肠道出血

IF 1.3 Q4 CLINICAL NEUROLOGY

Brain Hemorrhages Pub Date : 2025-10-01 DOI:10.1016/j.hest.2025.07.001

Yan Fu , Xiao Hu , Xiao-San Wu , Lei Zhu , Meng-Qiu Zhang , Yun-He Xia , Fang-Jian Zhu , Zi-Jie Wang , Chuan-Qin Fang , Qi Li

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引用次数: 0

摘要

目的超早期血肿生长（uHG）已被证明可预测脑出血（ICH）患者血肿扩张（HE）和预后不良。胃肠道出血，一种严重的脑出血并发症，已被发现与血肿体积相关。本研究分析了uHG与脑出血后消化道出血风险的相关性。方法前瞻性招募连续的脑出血患者。uHG被确定为基线计算机断层扫描（CT）上的血肿体积，除以从发病到CT的时间（ml/h）。单因素和多因素logistic回归模型确定了胃肠道出血的危险因素。采用受试者工作特征（ROC）曲线建立预测模型并进行评估。结果本研究共纳入138例患者，其中52例（37.7%）发生脑出血。多因素分析显示，uHG （aOR: 1.061; 95% CI: 1.002-1.123; p = 0.041）是脑出血患者胃肠道出血的独立预测因子。uHG也与90天预后显著相关（aOR: 1.109; 95% CI: 1.012-1.215; p = 0.026）。ROC分析显示uHG -纳入的预测模型对胃肠道出血具有较强的预测能力。结论：hg与原发性脑出血患者胃肠道出血风险增高和90天预后不良相关。

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Ultra-early hematoma growth predicts gastrointestinal bleeding after spontaneous intracerebral hemorrhage

Objective

Ultra-early hematoma growth (uHG) has been shown to predict hematoma expansion (HE) and poor outcomes in intracerebral hemorrhage (ICH) patients. Gastrointestinal bleeding, a severe ICH complication, has been found to correlate with hematoma volumes. This study analyzes the correlation between uHG and the risk of post-ICH gastrointestinal bleeding.

Method

We prospectively recruited consecutive ICH patients. uHG was identified as the hematoma volume on the baseline computed tomography (CT) scan, divided by time from onset to CT (ml/h). Univariate and multivariate logistic regression models identified risk factors for gastrointestinal bleeding. Predictive models were formulated and evaluated using receiver operating characteristic (ROC) curves.

Results

Our study involved 138 patients, and 52 (37.7 %) had gastrointestinal bleeding after ICH. Multivariate analysis revealed uHG (aOR: 1.061; 95 % CI: 1.002–1.123; p = 0.041) as an independent predictor of gastrointestinal bleeding in ICH patients. uHG also correlated significantly with 90-day outcomes (aOR: 1.109; 95 % CI: 1.012–1.215; p = 0.026). ROC analysis showed the uHG − incorporated predictive model had strong predictive power for gastrointestinal bleeding.