Predicting early hematoma enlargement in spontaneous intracerebral hemorrhage: Hypocalcemia, Hyperglycemia, and CT signs
Abstract
BACKGROUND
Spontaneous intracerebral hemorrhage (sICH) is a severe, stroke subtype, and early hematoma enlargement (HE) strongly predicts mortality and disability. This study aimed to investigate the predictive value of hypocalcemia, hyperglycemia, and computed tomography (CT) imaging signs for early HE in sICH.
METHODS
A total of 238 sICH patients admitted to the First People's Hospital Affiliated to Shanghai Jiao Tong University from November 2021 to November 2024 were retrospectively included. Patients were divided into the HE group (n = 103) and non-HE group (n = 135) based on HE occurrence. Univariate and multivariate logistic regression analyses were performed to identify independent risk factors for HE. Receiver operating characteristic (ROC) curves were used to evaluate the predictive efficiency of biochemical indicators [serum calcium (Ca²⁺), blood glucose (GLU)] and CT signs (blend sign, black hole sign, island sign), and a combined prediction model was constructed.
RESULTS
HE patients showed significantly lower Ca²⁺ levels (1.92 mmol/L vs. 2.41 mmol/L, P < 0.001) and higher GLU levels (8.38 mmol/L vs. 6.31 mmol/L, P < 0.001) compared with non-HE patients. Multivariate analysis revealed that hypocalcemia (≤2.24 mmol/L; OR=0.001, P < 0.001), hyperglycemia (≥7.96 mmol/L; OR=1.791, P = 0.006), and expansion-prone hematoma CT signs (OR=2.990, P < 0.001) were independent risk factors for HE. ROC curve analysis indicated that the combined prediction model of Ca²⁺…
How strong is the evidence?
Evidence Hub reads this as a cohort study, done in people. Its evidence level is 3 of 5 (Moderate · trial / cohort / secondary analysis). Trials without a large randomized design, cohorts and secondary analyses give moderate evidence. Reported size: 238 participants or records.
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