LAUSR

BACKGROUND Noncontrast computed tomography hypodensities (HD) and ultraearly hematoma growth (uHG) are reliable markers for outcome prediction in patients with spontaneous intracerebral hemorrhage (sICH). The present study aimed to assess whether the combination of these two markers could improve the prognostic value for sICH. METHODS We recruited 242 patients with sICH who were admitted within 6 hours from the onset of symptom. HD was assessed by two independent blinded readers. UHG was calculated as baseline ICH volume/onset-to-imaging time (OIT). We divided the study population into 4 groups: uHG(L) HD (-) (uHG＜6.16 mL/h and HD negative), uHG(L) HD (+) (uHG＜6.16 mL/h and HD positive), uHG(H) HD (-) (uHG≥6.16 mL/h and HD negative), and uHG(H) HD (+) (uHG≥6.16 mL/h and HD positive), respectively. The outcome at 90 days was evaluated by the modified Rankin Scale (mRS) score, and was dichotomized as good (mRS 0-3 points) and poor (mRS 4-6 points). The association between the combined indicators and unfavorable outcome were investigated by multivariable logistic regression models.methods RESULTS: Patients with poor outcomes were more likely to be accompanied with HD and higher uHG in univariate analysis. In multivariate logistic regression analysis, uHG(H) HD (+) had a higher risk of unfavorable outcomes (OR=5.710, P<0.001) compared with uHG(L) HD (-). In addition, the risk of unfavorable outcomeswas increased in uHG(H) HD (-) (OR=2.957, P=0.044) and uHG(L) HD (+) (OR=1.924 P=0.232). The proportions of unfavorable prognoses were 32.6% in uHG(L) HD (-), 48.3% in uHG(L) HD (+), 72.2% in uHG(H) HD (-), and 87.5% in uHG(H) HD (+) (P<0.001).results CONCLUSIONS: The combination of uHG and HD improves the stratification of unfavorable prognoses in patients with sICH.