Influencing factors of early hematoma expansion in spontaneous cerebral hemorrhage in multicenter population with complex altitude differences

Objective To investigate the influencing factors for early hematoma enlargement (HE) in patients with spontaneous intracerebral hemorrhage (SICH).

Methods A total of 311 patients with SICH were selected as research subjects. Based on the occurrence of HE, they were divided into enlargement group and non-enlargement group. Clinical assessment indicators of patients with SICH were collected, and general information between the two groups was compared. The influencing factors for the occurrence of HE in patients with SICH were analyzed.

Results Based on the presence of HE at a second CT examination within 6 to 12 hours, 311 patients with SICH were divided into enlargement group (n=97) and non-enlargement group (n=214). Univariate analysis revealed significant differences between the two groups in terms of initial hematoma volume, regularity of hematoma margin, Glasgow Coma Scale (GCS) score, coagulation function, as well as the presence of swirl sign, lobulation sign, black hole sign, blend sign, lymphocyte count and neutrophil count (P < 0.05). Multivariate analysis indicated that GCS score, initial hematoma volume, history of antithrombotic drug use, abnormal coagulation function and intracranial CT signs were independent influencing factors for HE (P < 0.05).

Conclusion The occurrence of HE in patients with SICH is closely related to GCS score, initial hematoma volume, history of antithrombotic drug use, abnormal coagulation function and intracranial CT signs.