Different Effects of Hematoma Expansion on Short-Term Functional Outcome in Basal Ganglia and Thalamic Hemorrhages

Purpose. To investigate the impact of hematoma expansion (HE) on short-term functional outcome of patients with thalamic and basal ganglia intracerebral hemorrhage. Methods. Data of 420 patients with deep intracerebral hemorrhage (ICH) that received a baseline CT scan within 6 hours from symptom ons...

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Autores principales:	Lijing Deng, Kai Chen, Liu Yang, Zhaoxu Deng, Haijun Zheng
Formato:	article
Lenguaje:	EN
Publicado:	Hindawi Limited 2021
Materias:	Medicine R
Acceso en línea:	https://doaj.org/article/74a4dcc9fdfa4f1d80449b5cf3c0ca4b
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spelling	oai:doaj.org-article:74a4dcc9fdfa4f1d80449b5cf3c0ca4b2021-11-08T02:36:35ZDifferent Effects of Hematoma Expansion on Short-Term Functional Outcome in Basal Ganglia and Thalamic Hemorrhages2314-614110.1155/2021/9233559https://doaj.org/article/74a4dcc9fdfa4f1d80449b5cf3c0ca4b2021-01-01T00:00:00Zhttp://dx.doi.org/10.1155/2021/9233559https://doaj.org/toc/2314-6141Purpose. To investigate the impact of hematoma expansion (HE) on short-term functional outcome of patients with thalamic and basal ganglia intracerebral hemorrhage. Methods. Data of 420 patients with deep intracerebral hemorrhage (ICH) that received a baseline CT scan within 6 hours from symptom onset and a follow-up CT scan within 72 hours were retrospectively analyzed. The poor functional outcome was defined as modified Rankin score mRS>3 at 30 days. Receiver operating characteristic (ROC) curves for relative and absolute growth of HE were generated and compared. Multivariable logistic regression models were used to analyze the impact of HE on the functional outcome in basal ganglia and thalamic hemorrhages. The predictive values for different thresholds of HE were calculated, and correlation coefficient matrices were used to explore the correlation between the covariables. Results. Basal ganglia ICH showed a higher possibility of absolute hematoma growth than thalamic ICH. The area under the curve (AUC) for absolute and relative growth of thalamic hemorrhage was lower than that of basal ganglia hemorrhage (AUC 0.71 and 0.67, respectively) in discriminating short-term poor outcome with an AUC of 0.59 and 0.60, respectively. Each threshold of HE independently predicted poor outcome in basal ganglia ICH (P<0.001), with HE>3 ml and > 6 ml showing higher positive predictive values and accuracy compared to HE>33%. In contrast, thalamic ICH had a smaller baseline volume (BV, 9.55±6.85 ml) and was more likely to initially involve the posterior limb of internal capsule (PLIC) (85/153, 57.82%), and the risk of HE was lower without PLIC involvement (4.76%, P=0.009). Therefore, in multivariate analysis, the effect of thalamic HE on poor prognosis was largely replaced by BV and the involvement of PLIC, and the adjusted odds ratios (ORs) of HE was not significant (P>0.05). Conclusion. Though HE is a high-risk factor for short-term poor functional outcome, it is not an independent risk factor in thalamic ICH, and absolute growth is more predictive of poor outcome than relative growth for basal ganglia ICH.Lijing DengKai ChenLiu YangZhaoxu DengHaijun ZhengHindawi LimitedarticleMedicineRENBioMed Research International, Vol 2021 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R
spellingShingle	Medicine R Lijing Deng Kai Chen Liu Yang Zhaoxu Deng Haijun Zheng Different Effects of Hematoma Expansion on Short-Term Functional Outcome in Basal Ganglia and Thalamic Hemorrhages
description	Purpose. To investigate the impact of hematoma expansion (HE) on short-term functional outcome of patients with thalamic and basal ganglia intracerebral hemorrhage. Methods. Data of 420 patients with deep intracerebral hemorrhage (ICH) that received a baseline CT scan within 6 hours from symptom onset and a follow-up CT scan within 72 hours were retrospectively analyzed. The poor functional outcome was defined as modified Rankin score mRS>3 at 30 days. Receiver operating characteristic (ROC) curves for relative and absolute growth of HE were generated and compared. Multivariable logistic regression models were used to analyze the impact of HE on the functional outcome in basal ganglia and thalamic hemorrhages. The predictive values for different thresholds of HE were calculated, and correlation coefficient matrices were used to explore the correlation between the covariables. Results. Basal ganglia ICH showed a higher possibility of absolute hematoma growth than thalamic ICH. The area under the curve (AUC) for absolute and relative growth of thalamic hemorrhage was lower than that of basal ganglia hemorrhage (AUC 0.71 and 0.67, respectively) in discriminating short-term poor outcome with an AUC of 0.59 and 0.60, respectively. Each threshold of HE independently predicted poor outcome in basal ganglia ICH (P<0.001), with HE>3 ml and > 6 ml showing higher positive predictive values and accuracy compared to HE>33%. In contrast, thalamic ICH had a smaller baseline volume (BV, 9.55±6.85 ml) and was more likely to initially involve the posterior limb of internal capsule (PLIC) (85/153, 57.82%), and the risk of HE was lower without PLIC involvement (4.76%, P=0.009). Therefore, in multivariate analysis, the effect of thalamic HE on poor prognosis was largely replaced by BV and the involvement of PLIC, and the adjusted odds ratios (ORs) of HE was not significant (P>0.05). Conclusion. Though HE is a high-risk factor for short-term poor functional outcome, it is not an independent risk factor in thalamic ICH, and absolute growth is more predictive of poor outcome than relative growth for basal ganglia ICH.
format	article
author	Lijing Deng Kai Chen Liu Yang Zhaoxu Deng Haijun Zheng
author_facet	Lijing Deng Kai Chen Liu Yang Zhaoxu Deng Haijun Zheng
author_sort	Lijing Deng
title	Different Effects of Hematoma Expansion on Short-Term Functional Outcome in Basal Ganglia and Thalamic Hemorrhages
title_short	Different Effects of Hematoma Expansion on Short-Term Functional Outcome in Basal Ganglia and Thalamic Hemorrhages
title_full	Different Effects of Hematoma Expansion on Short-Term Functional Outcome in Basal Ganglia and Thalamic Hemorrhages
title_fullStr	Different Effects of Hematoma Expansion on Short-Term Functional Outcome in Basal Ganglia and Thalamic Hemorrhages
title_full_unstemmed	Different Effects of Hematoma Expansion on Short-Term Functional Outcome in Basal Ganglia and Thalamic Hemorrhages
title_sort	different effects of hematoma expansion on short-term functional outcome in basal ganglia and thalamic hemorrhages
publisher	Hindawi Limited
publishDate	2021
url	https://doaj.org/article/74a4dcc9fdfa4f1d80449b5cf3c0ca4b
work_keys_str_mv	AT lijingdeng differenteffectsofhematomaexpansiononshorttermfunctionaloutcomeinbasalgangliaandthalamichemorrhages AT kaichen differenteffectsofhematomaexpansiononshorttermfunctionaloutcomeinbasalgangliaandthalamichemorrhages AT liuyang differenteffectsofhematomaexpansiononshorttermfunctionaloutcomeinbasalgangliaandthalamichemorrhages AT zhaoxudeng differenteffectsofhematomaexpansiononshorttermfunctionaloutcomeinbasalgangliaandthalamichemorrhages AT haijunzheng differenteffectsofhematomaexpansiononshorttermfunctionaloutcomeinbasalgangliaandthalamichemorrhages
_version_	1718443105934376960

Different Effects of Hematoma Expansion on Short-Term Functional Outcome in Basal Ganglia and Thalamic Hemorrhages

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