| Objective:To investigate the risk factors related to the prognosis of supratentorial moderate volume spontaneous cerebral hemorrhage,and to establish and validate the corresponding prognostic model,expecting to evaluate the prognosis of patients in advance in order to adjust the treatment plan and achieve the best prognosis.Methods:Retrospectively and continuously collect the medical records of patients with supratentorial moderate spontaneous intracerebral hemorrhage from January 2016 to June 2019 in the Department of Neurosurgery of the Affiliated Hospital of North Sichuan Medical College.Divided the group into poor prognosis group(GOS ≤3 points)and good prognosis group(GOS>3 points)according to the score.Then randomly split data into a training group and a validation group in a 2:1 ratio,and through analyzing the data information of the training group,a column line graph prediction model was established and brought into the validation group data for internal validation to assess the effectiveness of nomograms.Similarly,the above data of patients diagnosed with episodic moderate volume spontaneous cerebral hemorrhage from July 2019 to June 2021 in the Department of Neurosurgery of the Affiliated Hospital of North Sichuan Medical College were collected as model validation data for external validation of the model.Results:A total of 347 patients with moderate amount of spontaneous cerebral hemorrhage on the curtain were included in the internal validation study,with 132 patients(38.0%)in the poor prognosis group.In the univariate analysis affecting patient prognosis,patient prognosis was related to age,site of bleeding,bleeding breaking into the ventricle,admission systolic blood pressure,admission consciousness,pupillary changes,deep vein thrombosis,admission GCS score,surgical treatment,rehabilitation exercises,hyperbaric oxygen therapy,admission random blood glucose values,discharge hematoma volume,hematoma clearance rate,hematoma shape regularity,and length of stay.The above factors were included in logistic regression for multifactorial analysis,which finally yielded admission random blood glucose values(OR=1.382,95%CI=1.134-1.686,P=0.001),hemorrhage breaking into the ventricles(OR=4.023,95%CI=1.394-11.607,P=0.01),admission GCS scores(OR=0.521,95%CI=0.413-0.656,P<0.001),regular hematoma morphology(OR=0.236,95%CI=0.086-0.649,P=0.042),surgical treatment(OR=0.145,95%CI=0.042-0.499,P=0.002),rehabilitation exercise(OR=0.218,95%CI=0.071-0.671,P=0.008),hyperbaric oxygen therapy(OR=0.22,95%CI=0.075-0.646,P=0.006),and hematoma clearance(OR=0.129,95%CI=0.017-0.950,P=0.044)were influential factors regarding patient prognosis.The data related to multifactorial logistic regression were incorporated into R language to construct nomograms,ROC curves,calibration curves and DAC decision curves to identify and calibrate the training and validation groups,which confirmed that the column line plots predicted the prognosis of MSSCH patients well,and the efficacy of the prediction model was also confirmed in external validation.Conclusion:The prognostic models constructed in this study performed well in both internal and external validation,and could be used by clinicians to predict and assess the risk of adverse outcome in patients with moderate to moderate supratentorial spontaneous intracerebral hemorrhage for early intervention,timely change of treatment plan for clinical decision-making to provide reference. |
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