A Comparative Analysis Of Three ICH Scales In Predicting 30 Day Mortality Of Patients With Spontaneous Cerebral Hemorrhage

Objective: Combined with a retrospective clinical investigation of relatively large sample data,This article will analysis the value of three ICH scales(OICH scale,ICH-FOS scale,and MEDICH scale)in predicting and evaluating the 30-day mortality rate of patients with spontaneous intracerebral hemorrhage(SICH)and explore the risk factors that may affect the 30-day mortality of patients with spontaneous intracerebral hemorrhage,so as to provide clinical guidance for future treatment and evaluation of spontaneous intracerebral hemorrhage.Methods:1.500 cases patients of spontaneous intracerebral hemorrhage are selected from the the second and ninth clinical medical college of Shanxi Medical University from febuary2015 to febuary 2019.The population features and clinical data(such as age,gender,history of hypertension,smoking history,whether to take antiplatelet drugs and anticoagulants before onset,intracerebral hemorrage volume,hematoma location,GCS scale,NIHSS scale,blood sugar,INR value,etc.)were collected by self-made questionnaire.2.Use the OICH scale,the MEDICH scale and the ICH-FOS scale to evaluate the patients at the time of admission,and follow up the patients' survival after 30 days of onset.3.According to whether patients died with 30 days of onset,they were divided into death group(128 cases)and survival group(372 cases);Statistical methods will be used to compare the clinical characteristics of SICH patients in the survival and death groups,SPSS21.0 software will be used for statistical analysis.Logistic regression analysis was performed on the factors that affect the 30-day mortality of patients with SICH.The P value less than 0.05 indicates that the difference is statistically significant.The risk factors that may affect the 30-day mortality of patients are discussed.4.Draw the receiver operating characteristic(ROC)curve of the 30-day mortality of the subject.Based on the area under the curve,the Youden index,sensitivity,specificity,positive predictive value,negative predictive value,analyze the accuracy and the predictive value of the OICH scale,ICH-FOS scale and MEDICH scale in predicting the 30-day mortality rate of SICH patients.Results:1.In this study,the 30 day mortality rate of patients with spontaneous cerebral hemorrhage was 25.6%.After statistical analysis,there were significant differences between the two groups in age,antiplatelet drug use,GCS scale,NIHSS scale,hematoma volume,intraventricular hemorrhage,admission blood glucose(P < 0.05);but there was no significant difference in gender,history of hypertension,smoking history,supra-cranial hemorrhage,and application of anticoagulants before onset(P> 0.05).2.Logistic regression analysis showed that age,NIHSS scale,GCS scale,admission blood glucose,hematoma volume,bleeding into the ventricle,and use of antiplatelet drugs before the onset were risk factors that may affect the 30-day mortality.The differences were statistically significant(P < 0.05).3.The Youden index,sensitivity,specificity,positive predictive value,and negative predictive value of the ICH-FOS scale are higher than those of the OICH scale and the MEDICH scale.4.The area under ROC curve showed that the sensitivity and specificity of the ICH-FOS scale were higher than those of OICH scale and the MEDICH scale.Conclusion:1.Among the three scales,ICH-FOS has the highest predictive value for 30 day mortality rate of patients with spontaneous cerebral hemorrhage.2.The application of antiplatelet drugs before onset can increase the 30-day mortality of SICH patients,which may become a risk factor affecting the mortality of SICH patients.