ABSTRACT

Objective: In patients with spontaneous intracerebral hematoma (ICH), early-stage hematoma expansion has been associated with poor prognosis in literature. This study aimed to develop predictive parameter(s) as well as a new scale to define hematoma expansion and short-term prognosis in patients with ICH.

Methods: In 46 patients with ICH, Glasgow Coma Scale (GCS) scores, non-contrast CT (NCCT) markers (hematoma volume on admission and follow-up, hypodensity, intraventricular hemorrhage, blend and island sign, BAT score), and modified Rankin Scale scores were evaluated for predicting the hematoma expansion risk and mortality risk. Furthermore, a newly developed scale called the ‘HEMRICH scale’ was constituted using the GCS score, hematoma volumes, and some NCCT markers.

Results: Roc-Curve and Logistic Regression test results revealed that GCS score, initial hematoma volume value, hypodensity, intraventricular haemorrhage, BAT score, and HEMRICH scale score could be the best markers in predicting hematoma expansion risk whereas GCS score, intraventricular haemorrhage, BAT score, hematoma expansion, and HEMRICH scale score could be the best markers in predicting mortality risk (p = 0.01). Moreover, Factor analysis and Reliability test results showed that HEMRICH scale score could predict both hematoma expansion and mortality risks validly (Kaiser-Meyer-Olkin test value = 0.729) and reliably (Cronbach’s alpha = 0.564).

Conclusion: It was concluded that the GCS score, intraventricular haemorrhage, and BAT score could predict both hematoma expansion risk and mortality risk in the early stage in patients with ICH. Furthermore, it was suggested that the newly produced HEMRICH scale could be a valid and reliable scale for predicting both hematoma expansion and mortality risk.

摘要

目的：在自发性脑内血肿 (ICH) 患者中，文献中早期血肿扩大与不良预后相关。本研究旨在开发预测参数以及定义 ICH 患者血肿扩大和短期预后的新量表。

方法：在 46 例 ICH 患者中，格拉斯哥昏迷量表 (GCS) 评分、非增强 CT (NCCT) 标志物（入院和随访时血肿体积、低密度、脑室内出血、混合和岛征、BAT 评分）和改良Rankin 量表评分用于预测血肿扩大风险和死亡风险。此外，使用 GCS 评分、血肿体积和一些 NCCT 标记构成了新开发的称为“HEMRICH 量表”的量表。

结果：Roc-Curve和Logistic 回归测试结果显示，GCS 评分、初始血肿体积值、低密度、脑室内出血、BAT 评分和 HEMRICH 量表评分可能是预测血肿扩大风险的最佳标志，而 GCS 评分、脑室内出血、BAT评分、血肿扩大和 HEMRICH 量表评分可能是预测死亡风险的最佳标志物 (p = 0.01)。此外，因子分析和可靠性检验结果表明，HEMRICH 量表评分可以有效（Kaiser-Meyer-Olkin 检验值 = 0.729）和可靠地（Cronbach's alpha = 0.564）预测血肿扩大和死亡风险。

结论：GCS评分、脑室内出血和BAT评分可预测ICH患者早期血肿扩大风险和死亡风险。此外，有人建议新制作的 HEMRICH 量表可能是预测血肿扩大和死亡风险的有效且可靠的量表。