Development and validation of the hypertensive intracerebral hemorrhage prognosis models

Medicine (Baltimore). 2018 Sep;97(39):e12446. doi: 10.1097/MD.0000000000012446.

Abstract

To develop and validate the prognosis model of hypertensive intracerebral hemorrhage based on admission characteristics, which would be applied to predict the 3-month outcome.For developing the prognosis models, we studied data from 325 patients with retrospectively consecutive hypertensive intracerebral hemorrhage admitted between 2012 and 2016. The predictive value of admission characteristics was tested in logistic regression models, presenting 3-month outcome as the primary outcome. The performance of the models was tested by discrimination and calibration. After development, internal and external validations were used to test the function.The multivariate analysis of logistic regression indicated that age, Glasgow coma scale score, pupillary light reflex, hypoxemia, intracerebral hemorrhage volume, blood glucose, and D-dimer level were independent factors of the hypertensive intracerebral hemorrhage prognosis model. The prognosis model based on those admission risk factors worked well. The receiver operating characteristic curve was used to analyze the discriminant ability of model A, model A + B, and model A + B + C. Specifically, the area under the receiver operating characteristic curve increased from 0.816 (model A; 95% CI, 0.760-0.872) to 0.913 (model A + B + C; 95% CI, 0.881-0.946), and the models were not overoptimistic and were applicably confirmed by internal and external validations respectively.This prognosis model could be used to predict the prognosis of patients with hypertensive intracerebral hemorrhage early, simply and accurately, contributing to the clinical treatment eventually.

Publication types

  • Observational Study

MeSH terms

  • Aged
  • Aged, 80 and over
  • Blood Glucose / analysis
  • Cerebral Hemorrhage / diagnostic imaging
  • Cerebral Hemorrhage / mortality*
  • Cerebral Hemorrhage / physiopathology
  • Female
  • Fibrin Fibrinogen Degradation Products / analysis
  • Glasgow Coma Scale / standards
  • Hospitalization / statistics & numerical data
  • Humans
  • Hypertension / complications*
  • Hypertension / epidemiology
  • Hypertension / mortality
  • Hypoxia / mortality
  • Hypoxia / physiopathology
  • Intracranial Hemorrhage, Hypertensive / blood*
  • Intracranial Hemorrhage, Hypertensive / diagnostic imaging
  • Intracranial Hemorrhage, Hypertensive / metabolism
  • Intracranial Hemorrhage, Hypertensive / mortality*
  • Male
  • Middle Aged
  • Outcome Assessment, Health Care
  • Predictive Value of Tests
  • Prognosis
  • Reflex, Pupillary / physiology
  • Retrospective Studies
  • Risk Factors
  • Tomography, X-Ray Computed / methods

Substances

  • Blood Glucose
  • Fibrin Fibrinogen Degradation Products
  • fibrin fragment D