Predictive performance of non-contrast CT signs for hematoma expansion: A comparative analysis across traditional, revised, and conservative definitions
Abstract
BACKGROUND: Hematoma expansion (HE) is a critical determinant of neurological deterioration after spontaneous intracerebral hemorrhage (ICH). While non-contrast CT (NCCT) signs (Blend sign, Black hole sign, Hypodensities) are established predictors under traditional parenchymal-volume-based HE definitions, their performance under a revised composite definition that includes intraventricular hemorrhage (IVH) expansion remains unvalidated.
METHODS: In a retrospective cohort of 685 spontaneous ICH patients, HE was assessed using three definitions: traditional (parenchymal increase > 6 mL or > 33%), revised (traditional criteria and/or IVH expansion [≥ 1 mL or new IVH]), and conservative revised (IVH threshold > 2 mL). Multivariable logistic regression evaluated the independent association of NCCT signs with each definition. Model discrimination was compared using ROC analysis.
RESULTS: HE incidence was 17.08% (traditional), 21.90% (revised), and 20.15% (conservative revised). All three NCCT signs remained strong, independent predictors across all definitions after full adjustment (all p 12.5 mL or > 50% growth) and identified an additional subgroup with isolated IVH expansion.
CONCLUSION: The Blend sign, Black hole sign, and Hypodensities are robust predictors of HE that generalize effectively from traditional to IVH-inclusive composite definitions. Their predictive utility, combined with the time-dependent risk profile, supports their use for early, universal risk…
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: 685 participants or records.
Read the paper
Related studies
- A Survey on Knowledge Graphs: Representation, Acquisition, and Applications
- Toxicity of nanomaterials
- The Human Gene Mutation Database: towards a comprehensive repository of inherited mutation data for medical research, genetic diagnosis and next-generation sequencing studies
- Halogen bonding (X‐bonding): A biological perspective
- Biofilm formation at the air–liquid interface by the Pseudomonas fluorescens SBW25 wrinkly spreader requires an acetylated form of cellulose
- Opioid Activation of Toll-Like Receptor 4 Contributes to Drug Reinforcement
Go deeper in Evidence Hub
Evidence Hub adds a study data sheet (design, sample size, evidence level, key numbers), an AI summary and a chat grounded in the paper's text.