A Clinical Predictive Nomogram for Traumatic Brain Parenchyma Hematoma Progression

Overview

Journal Neurol Ther

Publisher Springer

Specialty Neurology

Date 2021 Dec 2

PMID 34855160

Citations 7

Authors

Jiangtao Sheng

Weiqiang Chen

Dongzhou Zhuang

Tian Li

Jinhua Yang

Shirong Cai

Xiaoxuan Chen

Xueer Liu

Fei Tian

Mindong Huang

Lianjie Li

Kangsheng Li

Affiliations

Soon will be listed here.

Abstract

Introduction: Acute traumatic intraparenchymal hematoma (tICH) expansion is a major cause of clinical deterioration after brain contusion. Here, an accurate prediction tool for acute tICH expansion is proposed.

Methods: A multicenter hospital-based study for multivariable prediction model was conducted among patients (889 patients in a development dataset and 264 individuals in an external validation dataset) with initial and follow-up computed tomography (CT) imaging for tICH volume evaluation. Semi-automated software was employed to assess tICH expansion. Two multivariate predictive models for acute tICH expansion were developed and externally validated.

Results: A total of 198 (22.27%) individuals had remarkable acute tICH expansion. The novel Traumatic Parenchymatous Hematoma Expansion Aid (TPHEA) model retained several variables, including age, coagulopathy, baseline tICH volume, time to baseline CT time, subdural hemorrhage, a novel imaging marker of multihematoma fuzzy sign, and an inflammatory index of monocyte-to-lymphocyte ratio. Compared with multihematoma fuzzy sign, monocyte-to-lymphocyte ratio, and the basic model, the TPHEA model exhibited optimal discrimination, calibration, and clinical net benefits for patients with acute tICH expansion. A TPHEA nomogram was subsequently introduced from this model to facilitate clinical application. In an external dataset, this device showed good predicting performance for acute tICH expansion.

Conclusions: The main predictive factors in the TPHEA nomogram are the monocyte-to-lymphocyte ratio, baseline tICH volume, and multihematoma fuzzy sign. This user-friendly tool can estimate acute tICH expansion and optimize personalized treatments for individuals with brain contusion.

Citing Articles

An updated review for clinical and radiological predictors of acute intraparenchymal hematoma progression in cerebral contusion.

Chen G, Kang H Heliyon. 2024; 10(21):e39907.

PMID: 39553672 PMC: 11566669. DOI: 10.1016/j.heliyon.2024.e39907.

Cerebral contusions - Pathomechanism, predictive factors for progression and historical and current management.

Jirlow U, Hossain I, Korhonen O, Depreitere B, Rostami E Brain Spine. 2024; 4:103329.

PMID: 39281852 PMC: 11402187. DOI: 10.1016/j.bas.2024.103329.

Imaging predictors of hemorrhagic progression of a contusion after traumatic brain injury: a systematic review and meta-analysis.

Peng J, Luo T, Li X, Li B, Cheng Y, Huang Q Sci Rep. 2024; 14(1):5961.

PMID: 38472247 PMC: 10933276. DOI: 10.1038/s41598-024-56232-w.

Low serum calcium is a novel predictor of unfavorable prognosis after traumatic brain injury.

Li T, Zhuang D, Cai S, Ding F, Tian F, Huang M Heliyon. 2023; 9(8):e18475.

PMID: 37576228 PMC: 10412893. DOI: 10.1016/j.heliyon.2023.e18475.

Epidemiological characteristics for patients with traumatic brain injury and the nomogram model for poor prognosis: an 18-year hospital-based study.

Guo S, Han R, Chen F, Ji P, Liu J, Zhai Y Front Neurol. 2023; 14:1138217.

PMID: 37288066 PMC: 10242078. DOI: 10.3389/fneur.2023.1138217.

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