Prediction of clinical outcome based on hematoma location and volume in intracerebral hemorrhage

Abstract

Background: Non-traumatic intracerebral hemorrhage (ICH), an neurological emergency carries a burden of mortality and long-term disability worldwide. Blood pressure and level of consciousness at the admission, location and volume of parenchymal hemorrhage, volume of intraventricular hemorrhage have been most consistently linked with poor outcome. Aim: To asssess a relationship between hematoma location, volume and clinical outcome in patients with acute ICH. Materials and Methods: An analytical study was carried out in Third State Central Hospital, between 2022 and 2024, and statistical analysis was performed using SPSS 25.0 program. Results: Total of 385 cases diagnosed with acute ICH included in the study. The clinical outcomes differed significantly according to ICH location and hematoma volume (р<0.001). Lobar ICH was associated with a significantly lower risk of poor outcome (OR, 0.458 [95% CI, 0.21–0.99]), and highest risk for poor outcome in intraventricular hemorrhage (OR, 2.03 [95% CI, 1.07-3.85]). The risk of poor outcome at 3 months were the highest for brainstem (OR, 3.36 [95% CI, 1.68-6.69]), intraventricular rupture (OR, 4.91 [95% CI, 3.16-7.63]), but lowest for infratentorial-located ICHs (OR, 0.42 [95% CI, 0.23-0.76]). All receiver operating characteristic models for location-specific vutoffs had good discriminant values (area under the curve >0.8), except in predicting good outcome for cerebellum and thalamus (<10.2 ml, <6.7 ml respectively). Conclusion: The interaction between hematoma volume and location exerted a direct effect on ICH outcome.