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Published on: July 28, 2018
Hematoma Ventricle Distance on Computed Tomography Predicts Poor Outcome in Intracerebral Hemorrhage
Lan Deng1, Yun-Dong Zhang2, Jian-Wen Ji2
1Department of Neurology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.
Insights
Hematoma ventricle distance (HVD) is a key predictor of poor outcomes in patients with intracerebral hemorrhage (ICH). A smaller HVD (≤ 2.5 mm) significantly increases the odds of poor functional outcomes at 90 days.
Area of Science:
- Neurology
- Radiology
- Clinical Medicine
Background:
- Intracerebral hemorrhage (ICH) is a critical condition with significant morbidity and mortality.
- Predicting clinical outcomes in ICH patients is essential for timely intervention and resource allocation.
Purpose of the Study:
- To investigate the relationship between hematoma ventricle distance (HVD) and clinical outcomes in patients with ICH.
- To establish HVD as a prognostic marker for ICH.
Main Methods:
- Prospective enrollment of 325 consecutive ICH patients.
- Retrospective review of CT scans to measure HVD (minimum distance from hematoma to ventricle).
- Logistic regression analysis to assess HVD's association with poor functional outcome (modified Rankin Scale 4-6) at 90 days, adjusting for multiple clinical factors.
Main Results:
- The median HVD was 2.4 mm.
- 36.6% of patients experienced poor functional outcomes at 3 months.
- An HVD ≤ 2.5 mm was significantly associated with increased odds of poor clinical outcome (OR, 3.59; 95% CI = 1.72-7.50; p = 0.001) after multivariable adjustment.
Conclusions:
- Hematoma ventricle distance (HVD) is a novel and useful predictor of ICH prognosis.
- HVD can aid physicians in stratifying patients for clinical trials and managing ICH.
Objective:
To investigate the relationship between hematoma ventricle distance (HVD) and clinical outcome in patients with intracerebral hemorrhage (ICH).
Methods:
We prospectively enrolled consecutive patients with ICH in a tertiary academic hospital between July 2011 and April 2018. We retrospectively reviewed images for all patients receiving a computed tomography (CT) within 6 h after onset of symptoms and at least one follow-up CT scan within 36 h. The minimum distance of hematoma border to nearest ventricle was measured as HVD. Youden index was used to evaluate the cutoff of HVD predicting functional outcome. Logistic regression model was used to assess the HVD data and clinical poor outcome (modified Rankin Scale 4-6) at 90 days.
Results:
A total of 325 patients were included in our final analysis. The median HVD was 2.4 mm (interquartile range, 0-5.7 mm), and 119 (36.6%) patients had poor functional outcome at 3 months. After adjusting for age, admission Glasgow coma scale, intraventricular hemorrhage, baseline ICH volume, admission systolic blood pressure, blood glucose, hematoma expansion, withdrawal of care, and hypertension, HVD ≤ 2.5 mm was associated with increased odds of clinical poor outcome [odd ratio, 3.59, (95%CI = 1.72-7.50); p = 0.001] in multivariable logistic regression analysis.
Conclusion:
Hematoma ventricle distance allows physicians to quickly select and stratify patients in clinical trials and thereby serve as a novel and useful addition to predict ICH prognosis.
