Completely and totally fucking useless for survivors. Survivors want you to reduce the hematoma volume. GET THERE! Predictions like this have no value for survivors.
EXPRESS: The coronal plane maximum diameter of deep intracerebral hemorrhage predicts functional outcome more accurately than hematoma volume
Abstract
Background:
Among prognostic imaging variables, the hematoma volume on admission CT has long been considered the strongest predictor of outcome and mortality in intracerebral hemorrhage (ICH).
Aims:
To examine whether different features of hematoma shape are associated with functional outcome in deep ICH.
Methods:
We analyzed 790 patients from the ATACH-2 trial, and 14 shape features were quantified. We calculated Spearman’s Rho to assess the correlation between shape features and 3-month modified Rankin scale (mRS) score, and the ROC-AUC to quantify the association between shape features and poor outcome defined as mRS>2 as well as mRS>3.
Results:
Among 14 shape features, the maximum ICH diameter in the coronal plane was the strongest predictor of functional outcome, with a maximum coronal diameter >~3.5 cm indicating higher 3-month mRS scores. The maximum coronal diameter versus hematoma volume yielded a Rho of 0.40 vs 0.35 (p=0.006), an AUC[mRS>2] of 0.71 vs 0.68 (p=0.004), and an AUC[mRS>3] of 0.71 vs 0.69 (p=0.029). In multiple regression analysis adjusted for known outcome predictors, the maximum coronal diameter was independently associated with 3-month mRS (p<0.001).
Conclusions:
A coronal-plane maximum diameter measurement offers greater prognostic value in deep ICH than hematoma volume. This simple shape metric may expedite assessment of admission head CTs, offer a potential biomarker for hematoma size eligibility criteria in clinical trials and may substitute volume in prognostic ICH scoring systems.
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