Multivariate logistic regression analysis of risk factors of hematoma enlargement in patients of hypertensive intracerebral hemorrhage within 24hrs of onset: A retrospective study of 265 cases from a single center in China / 解放军医学杂志

ABSTRACT

Objective To study the risk factors of hematoma enlargement in acute hypertensive cerebral hemorrhage (AHCH) patients within 24 hours after onset. Methods A retrospective review of clinical data of consecutive patients with AHCH who met the inclusion and exclusion criteria and admitted from Mar. 2008 to Mar. 2013 was performed. The patients' data included patients' demography, previous medical history, clinical features, findings of CT, results of laboratory examinations, and the use of traditional medicines for promoting blood circulation. Patients were divided into hematoma enlargement group and non-hematoma-enlargement group. Univariate analysis was performed on the above factors first, and then with the statistically significant factors used as independent variables, hematoma growth as dependent variables, logistic regression analysis was performed to investigate the possible independent relevant factors for the early enlargement of hematoma in AHCH patients. The risk factors and enlargement of hematoma served as independent variables, the data of mRS scale obtained from 3-month follow up as dependent variables, logistic regression was then performed to investigate the influence of acute hematoma enlargement during 3-month follow up in AHCH patients. mRS 0-2 was assigned as good recovery, and mRS 3-6 as serious disability or death. The inspection level was ct=0.05. Results Among 256 patients, 43 (16.8%) were found to have hematoma enlargement. Univariate analysis showed the risk factors led to hematoma enlargement in AHCH patients were gender (male), Glasgow coma scale at admission, NIHSS (National Institute of Health Stroke Scale) at admission, course of disease, and liver function (AST). However, only two factors, namely gender (male) and course of disease, were the independent risk factors of the hematoma enlargement in AHCH patients according to the multivariate regression analysis. In addition, logistic regression revealed that the hematoma enlargement was the independent risk factor influencing the final outcome of AHCH patients, and the hematoma volume, NIHSS, and course of disease were the independent risk factors influencing the outcome of 3 month follow up. ConclusionsA male AHCH patient with shorter duration from onset to admission (within 2 hours) should alert attending physician there would be a risk of hematoma expansion. Larger amount of bleeding, enlarged hematoma, higher NIHSS and shorter duration from onset to admission herald a poor prognosis.