Abstract

Spontaneous intracerebral hemorrhage (SICH) has been common in China with high morbidity and mortality rates. This study aims to develop a machine learning (ML)-based predictive model for the 90-day evaluation after SICH. We retrospectively reviewed 751 patients with SICH diagnosis and analyzed clinical, radiographic, and laboratory data. A modified Rankin scale (mRS) of 0–2 was defined as a favorable functional outcome, while an mRS of 3–6 was defined as an unfavorable functional outcome. We evaluated 90-day functional outcome and mortality to develop six ML-based predictive models and compared their efficacy with a traditional risk stratification scale, the intracerebral hemorrhage (ICH) score. The predictive performance was evaluated by the areas under the receiver operating characteristic curves (AUC). A total of 553 patients (73.6%) reached the functional outcome at the 3rd month, with the 90-day mortality rate of 10.2%. Logistic regression (LR) and logistic regression CV (LRCV) showed the best predictive performance for functional outcome (AUC = 0.890 and 0.887, respectively), and category boosting presented the best predictive performance for the mortality (AUC = 0.841). Therefore, ML might be of potential assistance in the prediction of the prognosis of SICH.

Highlights

  • Spontaneous intracerebral hemorrhage (SICH), which accounts for 10–30% of all strokes, is the most fatal and disabling type of hemorrhage [1,2,3]

  • We retrospectively reviewed SICH patients admitted to West China Hospital during a 2-year period, from 1 January 2018, to 31 December 2019

  • Some machine learning (ML)-based models performed significantly better than the ICH score in predicting both 90-day functional outcome and 90-day mortality

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Summary

Introduction

Spontaneous intracerebral hemorrhage (SICH), which accounts for 10–30% of all strokes, is the most fatal and disabling type of hemorrhage [1,2,3]. Because of the high disability and mortality rates of SICH, outcome-prediction models combining clinical presentations, laboratory data and imaging findings are of great significance and can ensure the optimal care [5]. Several prognostic tools have been proposed for outcome prediction in intracerebral hemorrhage (ICH) such as ICH score [6]. These tools are potentially useful for predicting prognosis, facilitating communication between clinicians, and selecting patients for interventions [7,8,9]

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