Clinical, Laboratory, and CT Morphological Factors Associated with 3-Month Functional Outcomes in Spontaneous Intracerebral Hemorrhage: A Retrospective Cohort Study
Abstract
Background/Objectives: Spontaneous intracerebral hemorrhage (ICH) is associated with high mortality and disability. We aimed to identify clinical, laboratory, and imaging factors independently associated with 3-month functional outcome across non-contrast computed tomography (NCCT) morphological markers, laboratory biomarkers, and established clinical scoring systems. Methods: This retrospective cohort study included 337 consecutive patients with spontaneous ICH admitted between 2019 and 2022. Admission clinical findings, laboratory parameters, NCCT morphological markers (swirl, blend, black hole, island, hypodensities, and satellite signs), volumetrically segmented hematoma volumes, and prognostic scores (ICH and FUNC scores) were recorded. Poor functional outcome was defined as modified Rankin Scale (mRS) 3–6 at 3 months. Independent predictors were identified using a primary Firth penalized multivariable logistic regression model; discrimination (area under the ROC curve, AUC), calibration, and optimism-corrected performance (1000-resample bootstrap) were assessed, and incremental value over the ICH and FUNC scores was tested with the DeLong method. Results: Poor functional outcome occurred in 60.2% of patients, and 3-month mortality was 36.8%. In the primary penalized model, independent predictors of poor outcome were lower admission Glasgow Coma Scale, larger hematoma volume, NCCT hypodensities, history of hypertension, and lower low-density lipoprotein (LDL)…
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: 337 participants or records.
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