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A nomogram to predict the risk of postoperative intracranial rebleeding in patients with spontaneous intracranial hematoma

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Abstract

The 30-day mortality rate of spontaneous cerebral hemorrhage (ICH) is approximately 30–50%. Surgery may improve the prognosis of patients with severe ICH. However, ICH survivors after surgery still face the risks of postoperative intracranial rebleeding (PIB), and clinical tools that accurately predict the risk of PIB occurrence are not available. Therefore, a retrospective study was performed. The population was divided into two groups according to the occurrence of PIB. Univariate and multivariate logistic regression analyses were performed to screen risk factors for PIB. Next, an early PIB risk nomogram prediction model was constructed. In addition, the impact of PIB on the prognosis of ICH was evaluated. In total, 150 ICH patients were continuously enrolled in this study; 21 patients suffered from PIB, and the overall incidence of PIB was 14.0% (21/150). Coronary heart disease history, a lower GCS score, and subarachnoid hemorrhage absence were screened as risk factors for early PIB. The early PIB risk nomogram showed good calibration and discrimination with a concordance index of 0.807 (95% confidence interval (CI), 0.715–0.899), which was confirmed to be 0.788 through bootstrapping validation. In addition, a significant difference in discharged GOS scores (P = 0.043) was observed between the PIB group and the n-PIB group. These results showed that a history of coronary heart disease, a lower GCS score, and absence of subarachnoid hemorrhage were risk factors for early PIB. In addition, the early PIB risk nomogram prediction model exhibits good discrimination and calibration. The occurrence of PIB could reduce the prognosis of ICH patients.

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Availability of data and material

Data that support the findings of this study are available from the corresponding author on reasonable request.

Code availability

Codes for analyzing the data of this study are available from the corresponding author on reasonable request.

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Funding

This study is supported by two projects: National Natural Science Foundation of China (Grant Nos. 81471210 and 81671129) and major special projects in the 13th five-year plan (Grant No. 2016YFC1301800).

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Authors and Affiliations

  1. Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, NO.119 Nansihuanxilu, Fengtai District, 100160, Beijing, People’s Republic of China

    Junhua Yang, Yang Liu, Qingyuan Liu, Kaiwen Wang, Shaohua Mo, Maogui Li, Jun Wu, Pengjun Jiang, Shuzhe Yang, Rui Guo, Yi Yang, Jiaming Zhang, Yong Cao & Shuo Wang

  2. China National Clinical Research Center for Neurological Diseases, Beijing, People’s Republic of China

    Junhua Yang, Yang Liu, Qingyuan Liu, Kaiwen Wang, Shaohua Mo, Maogui Li, Jun Wu, Pengjun Jiang, Shuzhe Yang, Rui Guo, Yi Yang, Jiaming Zhang, Yong Cao & Shuo Wang

  3. Center of Stroke, Beijing Institute for Brain Disorders, Beijing, People’s Republic of China

    Junhua Yang, Yang Liu, Qingyuan Liu, Kaiwen Wang, Shaohua Mo, Maogui Li, Jun Wu, Pengjun Jiang, Shuzhe Yang, Rui Guo, Yi Yang, Jiaming Zhang, Yong Cao & Shuo Wang

  4. Beijing Key Laboratory of Translational Medicine for Cerebrovascular Diseases, Beijing, People’s Republic of China

    Junhua Yang, Yang Liu, Qingyuan Liu, Kaiwen Wang, Shaohua Mo, Maogui Li, Jun Wu, Pengjun Jiang, Shuzhe Yang, Rui Guo, Yi Yang, Jiaming Zhang, Yong Cao & Shuo Wang

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  1. Junhua Yang
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  2. Yang Liu
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  3. Qingyuan Liu
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  4. Kaiwen Wang
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  7. Jun Wu
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  9. Shuzhe Yang
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  13. Yong Cao
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  14. Shuo Wang
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Contributions

All authors contributed to the study’s conception and design. Conceptualization: Shuo Wang; methodology: Junhua Yang, Yang Liu, Jiaming Zhang, and Pengjun Jiang; formal analysis and investigation: Junghua Yang, Qingyuan Liu, Kaiwen Wang, Maogui Li, and Shaohua Mo; writing – original draft preparation: Junhua Yang; writing – review and editing: Jun Wu, Shuzhe Yang, Rui Guo, and Yi Yang; Supervision: Shuo Wang and Yong Cao.

Corresponding author

Correspondence to Shuo Wang.

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This study was performed in line with the principles of the Declaration of Helsinki. Approval was granted by the Ethics Committee of Beijing Tiantan Hospital, Capital Medical University (reference number: KY2019-096–02).

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Informed consent was obtained from all individual participants included in the study.

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Yang, J., Liu, Y., Liu, Q. et al. A nomogram to predict the risk of postoperative intracranial rebleeding in patients with spontaneous intracranial hematoma. Neurosurg Rev 45, 1571–1578 (2022). https://doi.org/10.1007/s10143-021-01682-3

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