Risk factors and nomogram for cognitive impairment after stereotactic drainage of spontaneous intracerebral...

To investigate the risk factors for cognitive impairment after stereotactic puncture and drainage for spontaneous intracerebral hemorrhage (SICH) and to establish a nomogram prediction model.

A retrospective analysis was conducted on 143 patients who underwent stereotactic puncture and drainage for SICH between June 2022 and June 2024. Patients were divided into cognitive impairment group (n = 57) and non-cognitive impairment group (n = 86) based on Montreal Cognitive Assessment at 3 months postoperatively. Univariate and multivariate logistic regression analyses were performed to identify independent risk factors, and a nomogram was constructed.

The incidence of cognitive impairment at 3 months was 39.86% (57/143). Multivariate logistic regression identified five independent risk factors: age (OR = 1.145, 95% CI: 1.089-1.205, p < 0.001), preoperative GCS score (OR = 0.512, 95% CI: 0.387-0.677, p < 0.001), hematoma volume (OR = 1.067, 95% CI: 1.028-1.108, p = 0.001), basal ganglia hemorrhage (OR = 5.567, 95% CI: 2.748-12.334, p < 0.001), and postoperative intracranial pressure (OR = 1.315, 95% CI: 1.168-1.481, p < 0.001). A nomogram integrating these five predictors was developed.

Advanced age, lower preoperative GCS score, larger hematoma volume, basal ganglia hemorrhage, and elevated postoperative intracranial pressure are independent risk factors for cognitive impairment at 3 months following stereotactic drainage for SICH. The nomogram may assist in early identification of high-risk patients, though external validation is warranted.