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. 2022 May 20;12(1):8552.
doi: 10.1038/s41598-022-12536-3.

Irregular shape as an independent predictor of prognosis in patients with primary intracerebral hemorrhage

Chunyang Liu #  1   2 , Haopeng Zhang #  1   2 , Lixiang Wang #  1   2 , Qiuyi Jiang  1   2 , Enzhou Lu  1   2 , Chao Yuan  1   2 , Yanchao Liang  1   2 , Zhenying Sun  1   2 , Huan Xiang  1   2 , Xun Xu  1   2 , Jingxian Sun  1   2 , Bo Fu  3 , Boxian Zhao  1   2 , Daming Zhang  1   2 , Xin Chen  1   2 , Ning Wang  4   5 , Lu Wang  6 , Guang Yang  7   8
Affiliations

Irregular shape as an independent predictor of prognosis in patients with primary intracerebral hemorrhage

Chunyang Liu et al. Sci Rep. .

Abstract

The utility of noncontrast computed tomography markers in the prognosis of spontaneous intracerebral hemorrhage has been studied. This study aimed to investigate the predictive value of the computed tomography (CT) irregularity shape for poor functional outcomes in patients with spontaneous intracerebral hemorrhage. We retrospectively reviewed all 782 patients with intracranial hemorrhage in our stroke emergency center from January 2018 to September 2019. Laboratory examination and CT examination were performed within 24 h of admission. After three months, the patient's functional outcome was assessed using the modified Rankin Scale. Multinomial logistic regression analyses were applied to identify independent predictors of functional outcome in patients with intracerebral hemorrhage. Out of the 627 patients included in this study, those with irregular shapes on CT imaging had a higher proportion of poor outcomes and mortality 90 days after discharge (P < 0.001). Irregular shapes were found to be significant independent predictors of poor outcome and mortality on multiple logistic regression analysis. In addition, the increase in plasma D-dimer was associated with the occurrence of irregular shapes (P = 0.0387). Patients with irregular shapes showed worse functional outcomes after intracerebral hemorrhage. The elevated expression level of plasma D-dimers may be directly related to the formation of irregular shapes.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Figure 1
Figure 1
Flowchart of patient enrollment.
Figure 2
Figure 2
Distribution of the modified Rankin Scale (mRS) scores according to the presence or absence of irregular shapes. The bold line separates favorable (mRS, 0–3) and poor outcomes (mRS, 4–6) or survival and death.
Figure 3
Figure 3
Receiver operating characteristic curves of irregular shape, island sign, blend sign, and IHV with their corresponding areas under the curve (AUCs) for predicting poor prognosis. The best cut-off points were identified with their sensitivity, specificity, and confidence interval (CI), respectively.
Figure 4
Figure 4
Kaplan–Meier curve analysis showing that the overall survival of patients with spontaneous intracerebral hemorrhage with irregular shapes in intracranial hematoma as worse than that with stable hematoma.
Figure 5
Figure 5
Scatter plot showing the relationship between the irregular shape and plasma D-dimer expression level. The appearance of irregular shapes in patients is often accompanied by an increase in plasma D-dimer expression on admission.
See this image and copyright information in PMC

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