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. 2025 Mar 28:12:1535443.
doi: 10.3389/fmed.2025.1535443. eCollection 2025.

A nomogram based on systemic inflammation response index and clinical risk factors for prediction of short-term prognosis of very elderly patients with hypertensive intracerebral hemorrhage

Shen Wang #  1   2 , Ruhai Wang #  3 , Xianwang Li  4 , Xin Liu  5 , Jianmei Lai  3 , Hongtao Sun  1   2 , Haicheng Hu  3
Affiliations

A nomogram based on systemic inflammation response index and clinical risk factors for prediction of short-term prognosis of very elderly patients with hypertensive intracerebral hemorrhage

Shen Wang et al. Front Med (Lausanne). .

Abstract

Objective: To develop and validate a nomogram based on systemic inflammation response index (SIRI) and clinical risk factors to predict short-term prognosis in very elderly patients with hypertensive intracerebral hemorrhage (HICH).

Methods: A total of 324 very elderly HICH patients from January 2017 to June 2024 were retrospectively enrolled and randomly divided into two cohorts for training (n = 227) and validation (n = 97) according to the ratio of 7:3. Independent predictors of poor prognosis were analyzed using univariate and multivariate logistic regression analyses. Furthermore, a nomogram prediction model was built. The area under the receiver operating characteristic curves (AUC), calibration plots and decision curve analysis (DCA) were used to evaluate the performance of the nomogram in predicting the prognosis of very elderly HICH.

Results: By univariate and stepwise multivariate logistic regression analyses, GCS score (p < 0.001), hematoma expansion (p = 0.049), chronic obstructive pulmonary disease (p = 0.010), and SIRI (p = 0.005) were independent predictors for the prognosis in very elderly patients with HICH. The nomogram showed the highest predictive efficiency in the training cohort (AUC = 0.940, 95% CI: 0.909 to 0.971) and the validation cohort (AUC = 0.884, 95% CI: 0.813 to 0.954). The calibration curve indicated that the nomogram had good calibration. DCA showed that the nomogram had high applicability in clinical practice.

Conclusion: The nomogram incorporated with the SIRI and clinical risk factors has good potential in predicting the short-term prognosis of very elderly HICH.

Keywords: nomogram; poor prognosis; risk factors; systemic inflammation response index; very elderly hypertensive intracerebral hemorrhage.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Flow chart for patient selection.
Figure 2
Figure 2
Boxplots of SIRI showing the distribution in the good outcome group (n = 139) and poor outcome group (n = 185). The SIRI of the poor outcome group was higher than that of the good outcome group (<0.001).
Figure 3
Figure 3
Predictive nomogram model for assessing the short-term prognosis in very elderly patients with hypertensive intracerebral hemorrhage.
Figure 4
Figure 4
Receiver operating characteristic curve of predicting the short-term prognosis in very elderly patients with hypertensive intracerebral hemorrhage by the nomogram model. Training group (A), validation group (B).
Figure 5
Figure 5
Calibration curve for predicting the short-term prognosis in very elderly patients with hypertensive intracerebral hemorrhage by the nomogram model. Training group (A), validation group (B).
Figure 6
Figure 6
Decision curve analysis for predicting the short-term prognosis in very elderly patients with hypertensive intracerebral hemorrhage by the nomogram model. Training group (A), validation group (B).
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