Influencing factors of hematoma enlargement after spontaneous intracerebral hemorrhage

Abstract

Objective To investigate the influencing factors of hematoma enlargement after spontaneous intracerebral hemorrhage. Methods The patients with spontaneous intracerebral hemorrhage were enrolled retrospectively in the study. The demographics, vascular risk factors, and baseline clinical data of the patients were collected. Hematoma enlargement was defined as CT scan within 48 h showed that the increased hematoma volume was more than >1/3 of the baseline. The demographics, vascular risk factors, and baseline clinical data of the hematoma enlargement group and the non-hematoma enlargement group were compared. Multivariate logistic regression analysis was use to identify the risk factors for hematoma enlargement. Results A total of 121 patients with spontaneous intracerebral hemorrhage were enrolled, including 69 males and 52 females, their ages were 24 to 89 years (mean 59.16±12.68). Forty-five patients (37.2%) had combined hypertension, 5 (4.1%) had diabetes, and 11 (9.1%) had hyperlipoidemia. Thirty patients (24.79%) had hematoma enlargement within 48 h. The time from ictus to the first CT scan was 4.21±1.57 h and the time from ictus to CT scan again was 34.78±6.90 h. Univariate analysis showed that the proportion of patients drinking alcohol (46.7% vs. 26.4%; χ2=4.313, P=0.038), as well as systolic blood pressure (174.53±20.02 mmHg vs. 160.63±19.79 mmHg, t=-3.327, P=0.001; 1 mmHg=0.133 kPa), fasting blood glucose (7.67[6.70-9.47]mmol/L vs.6.78[5.81-7.79]mmol/L; Z=-2.266, P=0.023), National Institutes of Health Stroke Scale (NIHSS) score (10.00[8.00-12.00] vs.5.00[3.00-8.00]; Z=-5.468, P<0.001) in the hematoma enlargement group were significantly higher than those in the non-hematoma enlargement group, while low-density lipoprotein cholesterol (2.60[2.10-2.91]mmol/L vs.3.00[2.60-3.41]mmol/L; Z=-3.905, P<0.001) was significantly lower than that in the non-hematoma enlargement group. Multivariate logistic regression analysis showed that baseline systolic blood pressure (odds ratio [OR] 1.036, 95% confidence interval [CI] 1.007-1.065; P=0.014) and NIHSS score (OR 1.310, 95% CI 1.111-1.544; P=0.001) were the independent risk factors for hematoma enlargement, while low-density lipoprotein cholesterol (OR 0.279, 95% CI 10.105-0.742; P=0.011) was the independent protective factor for hematoma enlargement. Conclusions Systolic blood pressure and NIHSS score were the independent risk factors for hematoma enlargement after spontaneous intracerebral hemorrhage, while low-density lipoprotein cholesterol was the independent protective factor for hematoma enlargement. Key words: Cerebral Hemorrhage; Hematoma; Blood Pressure; Risk Factors