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Published on: September 22, 2012
Comparative associations of three nutritional indices with hematoma expansion after intracerebral hemorrhage
Shuang Zhao1, Lin Zhang1, Qinyu Zhou1
1School of Clinical Medicine, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China.
Background:
Hematoma expansion (HE) is a major determinant of early neurological deterioration after intracerebral hemorrhage (ICH) and remains a key target for early risk assessment. Nutritional indices obtained at hospital admission can reflect acute physiological vulnerability during hemorrhagic injury, but their relative relevance to HE has not been well established. This study investigated the associations between three commonly used nutritional indices and HE in patients with ICH.
Methods:
We retrospectively included patients with ICH admitted between January 2023 and December 2024. Nutritional status at admission was assessed using the Prognostic Nutritional Index (PNI), the Triglycerides × Total Cholesterol × Body Weight Index (TCBI), and the Controlling Nutritional Status (CONUT) score. HE was defined as a relative hematoma growth >33% or an absolute increase >6 mL on follow-up computed tomography. Associations between each nutritional index and HE were examined using univariable and multivariable logistic regression. Restricted cubic spline (RCS) analysis was used to characterize the association pattern, and subgroup and sensitivity analyses were performed to evaluate consistency of the findings.
Results:
Among 349 included patients, 42 (12.0%) developed HE. Higher CONUT scores were significantly associated with an increased risk of HE (OR = 1.29, 95%CI: 1.03-1.59, p = 0.02). In contrast, neither PNI nor TCBI demonstrated significant associations after multivariable adjustment. RCS analyses indicated a significant overall relationship between CONUT and HE without evidence of nonlinearity. This association remained consistent across predefined subgroups with no significant interactions and was confirmed in sensitivity analyses.
Conclusion:
This study demonstrated a significant association between nutritional status and HE in ICH. Among the nutritional indices examined, CONUT showed a positive association, suggesting its role as a practical nutritional risk indicator for early risk stratification of HE in ICH.
