Lixiang Wang1, Chunyang Liu2, Enzhou Lu3, Daming Zhang4, Haopeng Zhang4, Xun Xu4, Rui Liu4, Chao Yuan4, Jingxian Sun4, Qi Zhou5, Xin Chen6, Lu Wang7, Guang Yang8. 1. Department of Neurosurgery, The First Affiliated Hospital of Harbin Medical University, 150001 Harbin, China; Institute of Brain Science, Harbin Medical University, 150001 Harbin, China. Electronic address: lixiangwang@hrbmu.edu.cn. 2. Department of Neurosurgery, The First Affiliated Hospital of Harbin Medical University, 150001 Harbin, China; Institute of Brain Science, Harbin Medical University, 150001 Harbin, China. Electronic address: 2020020898@hrbmu.edu.cn. 3. Department of Neurosurgery, The First Affiliated Hospital of Harbin Medical University, 150001 Harbin, China; Institute of Brain Science, Harbin Medical University, 150001 Harbin, China. Electronic address: 2019020831@hrbmu.edu.cn. 4. Department of Neurosurgery, The First Affiliated Hospital of Harbin Medical University, 150001 Harbin, China; Institute of Brain Science, Harbin Medical University, 150001 Harbin, China. 5. Research Administration Office, The First Affiliated Hospital of Harbin Medical University, Harbin, China. 6. Institute of Brain Science, Harbin Medical University, 150001 Harbin, China. 7. Department of Urology (Heilongjiang Key Laboratory of Scientific Research in Urology), The Fourth Hospital of Harbin Medical University, 150081 Harbin, China. Electronic address: wanglukaixin360@163.com. 8. Department of Neurosurgery, The First Affiliated Hospital of Harbin Medical University, 150001 Harbin, China; Institute of Brain Science, Harbin Medical University, 150001 Harbin, China. Electronic address: yangguang@hrbmu.edu.cn.
Abstract
OBJECTIVES: The initial hematoma volume is reliable and stable imaging predictor for the outcome of patients with intracerebral hemorrhage, and the total intracranial volume varies between patients. However, the role of total intracranial volume in predicting the prognosis of spontaneous intracerebral hemorrhage has not been previously addressed. METHODS: 782 patients with spontaneous intracerebral hemorrhage were selected in this retrospective cohort at the Neurosurgery Emergency Unit of The First Affiliated Hospital of Harbin Medical University. Due to missing CT images, initial CT exceeding 24 h, traumatic cerebral hemorrhage, and aneurysm, 145 patients were excluded and the remaining 637 patients were included in our analysis. Functional outcome was assessed using the modified Rankin Scale(mRS) and mortality at 3-months after spontaneous intracerebral hemorrhage. CT image datasets were calculated by 3D-Slicer. The initial hematoma volume was normalized to the total intracranial volume to evaluate poor functional outcomes (mRS, 4-6) and mortality. RESULTS: The results demonstrated that normalized initial hematoma volume can be used as an indicator of poor functional outcome (mRS, 4-6) (AUCNrIHV=0.753, 95%-CI:0.710-0.795, p < 0.001), mortality (AUCNrIHV=0.808, 95%-CI:0.754-0.862, p < 0.001) and hematoma expansion (AUCNrIHV=0.690, 95%-CI:0.613-0.767, p < 0.001). Meanwhile, the initial hematoma volume in predicting poor functional outcome (AUCIHV=0.749, 95%-CI:0.707-0.792, p < 0.001), mortality (AUCIHV=0.816, 95%-CI: 0.763-0.870, p < 0.001) and hematoma expansion (AUCIHV=0.704, 95%-CI: 0.626-0.782, p < 0.001) was similar to the normalized initial hematoma volume. CONCLUSIONS: The normalized initial hematoma volume has no apparent benefit in predicting the prognosis of patients with cerebral hemorrhage compared with initial hematoma volume.
OBJECTIVES: The initial hematoma volume is reliable and stable imaging predictor for the outcome of patients with intracerebral hemorrhage, and the total intracranial volume varies between patients. However, the role of total intracranial volume in predicting the prognosis of spontaneous intracerebral hemorrhage has not been previously addressed. METHODS: 782 patients with spontaneous intracerebral hemorrhage were selected in this retrospective cohort at the Neurosurgery Emergency Unit of The First Affiliated Hospital of Harbin Medical University. Due to missing CT images, initial CT exceeding 24 h, traumatic cerebral hemorrhage, and aneurysm, 145 patients were excluded and the remaining 637 patients were included in our analysis. Functional outcome was assessed using the modified Rankin Scale(mRS) and mortality at 3-months after spontaneous intracerebral hemorrhage. CT image datasets were calculated by 3D-Slicer. The initial hematoma volume was normalized to the total intracranial volume to evaluate poor functional outcomes (mRS, 4-6) and mortality. RESULTS: The results demonstrated that normalized initial hematoma volume can be used as an indicator of poor functional outcome (mRS, 4-6) (AUCNrIHV=0.753, 95%-CI:0.710-0.795, p < 0.001), mortality (AUCNrIHV=0.808, 95%-CI:0.754-0.862, p < 0.001) and hematoma expansion (AUCNrIHV=0.690, 95%-CI:0.613-0.767, p < 0.001). Meanwhile, the initial hematoma volume in predicting poor functional outcome (AUCIHV=0.749, 95%-CI:0.707-0.792, p < 0.001), mortality (AUCIHV=0.816, 95%-CI: 0.763-0.870, p < 0.001) and hematoma expansion (AUCIHV=0.704, 95%-CI: 0.626-0.782, p < 0.001) was similar to the normalized initial hematoma volume. CONCLUSIONS: The normalized initial hematoma volume has no apparent benefit in predicting the prognosis of patients with cerebral hemorrhage compared with initial hematoma volume.