Intensive Care Unit, Yuebei People's Hospital of Shantou University Medical, Shaoguan, Guangdong, China.
Neurosurgery, Yuebei People's Hospital of Shantou University Medical, Shaoguan, Guangdong, China.
Sci Rep. 2024 Nov 27;14(1):29505. doi: 10.1038/s41598-024-81106-6.
The objective of this study is to investigate key prognostic factors of clinical data and prognostic factors in patients with hypertensive intracerebral hemorrhage (HICH) who have undergone neuroendoscopic hematoma evacuation, specifically focusing on those with a hemorrhage volume of 20-40 mL, to identify the determinants influencing their prognosis. In this study, a total of 113 patients were ultimately included in the analysis. Variables such as age, preoperative Glasgow Coma Scale (GCS) scores, and hemorrhage locations were assessed. LASSO logistic regression was employed to select pertinent variables, which were then incorporated into a multivariate logistic regression model. The model's performance was evaluated using ROC and calibration curves, along with clinical utility curves, and the recovery times of patients were analyzed using Kaplan-Meier curves, complemented by COX regression analysis. These three variables-Age (OR: 0.811; 95% CI 0.711-0.925), GCS score (OR: 25.923; 95% CI 4.108-163.598), and ICH location (OR: 7.345; 95% CI 1.811-29.783)-are strong predictors of intracerebral hemorrhage prognosis. Among the patients analyzed, 85.84% experienced a favorable prognosis. Younger age, higher preoperative GCS scores, and hemorrhages located in the basal ganglia and cerebral lobes were associated with better outcomes (mRS score of 0-3) . The nomogram, validated by an ROC curve analysis yielding an AUC of 0.9417 and the Hosmer-Lemeshow test, demonstrated accurate predictive and calibration capabilities for postoperative prognosis in patients with hypertensive intracerebral hemorrhage. Kaplan-Meier intervals and COX regression analysis indicated that age is a significant factor affecting the recovery time of these patients. Age, GCS score, and ICH location are significant prognostic factors for patients undergoing neuroendoscopic hematoma evacuation following hypertensive intracerebral hemorrhage, with age being a particularly important determinant of recovery time. Younger age, higher GCS scores, and lobar hemorrhage are associated with better prognosis.
本研究旨在探讨高血压性脑出血（HICH）患者神经内镜血肿清除术后临床资料和预后因素的关键预后因素，特别是关注出血量为 20-40ml 的患者，以确定影响其预后的决定因素。本研究共纳入 113 例患者进行分析。评估了年龄、术前格拉斯哥昏迷量表（GCS）评分和出血部位等变量。采用 LASSO 逻辑回归选择相关变量，然后将这些变量纳入多变量逻辑回归模型。使用 ROC 和校准曲线以及临床实用曲线评估模型性能，并通过 Kaplan-Meier 曲线分析患者的恢复时间，同时采用 COX 回归分析进行补充。年龄（OR：0.811；95%CI 0.711-0.925）、GCS 评分（OR：25.923；95%CI 4.108-163.598）和 ICH 部位（OR：7.345；95%CI 1.811-29.783）这三个变量是脑出血预后的强有力预测因素。在分析的患者中，85.84%预后良好。年龄较小、术前 GCS 评分较高以及基底节和大脑叶出血与更好的结局（mRS 评分 0-3）相关。该列线图通过 ROC 曲线分析得到 AUC 为 0.9417 和 Hosmer-Lemeshow 检验验证，显示了对高血压性脑出血患者术后预后的准确预测和校准能力。Kaplan-Meier 间隔和 COX 回归分析表明，年龄是影响这些患者恢复时间的重要因素。年龄、GCS 评分和 ICH 部位是高血压性脑出血患者神经内镜血肿清除术后的重要预后因素，年龄是恢复时间的重要决定因素。年龄较小、GCS 评分较高和叶出血与更好的预后相关。
