The Relationship Between Blood Cell Parameters And Prognosis Of Hypertensive Intracerebral Hemorrhage

Objective:To explore the relationship between red blood cell parameters and the prognosis of hypertensive cerebral hemorrhage,and to build a predictive model for the prognosis of hypertensive cerebral hemorrhage through blood cell parameters,which provides a reference for the treatment and prognosis of hypertensive cerebral hemorrhage.Methods:Patients with hypertensive cerebral hemorrhage admitted to the Department of Neurosurgery of Hebei Engineering University from January 2018 to March 2019 were included.According to the mRS scores of patients 90 days after onset,they were divided into poor prognosis group and good prognosis group.Patients’ clinical data,treatment methods,blood cell parameters on the first,third and seventh days of admission,and follow-up were recorded.The single factor analysis of SPSS 25.0 software was used to screen the relevant factors for the prognosis of hypertensive cerebral hemorrhage.The multivariate logistic regression analysis was used to analyze the relationship between blood cell parameters and related factors and the prognosis of hypertensive cerebral hemorrhage.Survival analysis was performed using the Kapian-Meier method and survival curves were drawn Cox proportional regression model was used to analyze the prognostic factors of hypertensive cerebral hemorrhage.ROC curve was used to analyze the statistically significant factors.The area under the curve was calculated to evaluate its prognostic value.Results:The univariate analysis of the prognosis of hypertensive cerebral hemorrhage showed statistically significant differences in age,bleeding volume,GCS score,drinking history,RBC,HCT,Hb on the third day of admission and Hb on the seventh day of admission(P<0.05).Multivariate Logistic regression analysis showed that the OR values of group Q4 relative to group Q1 were 0.02,1.26,3.06,0.02 and 0.05 respectively,based on GCS score(>9),alcohol consumption,hemorrhage(>35ml),RBC and HCT on the third day after admission.And the OR values of Q3 and Q4 groups minus the HCT difference on the first day of admission were 4.00 and 2.80 compared with Q1 group,the difference was statistically significant(P<0.05).The results of the Cox proportional regression model showed that the HR values for age(>65 years)and GCS scores≥9 were 0.92 and 2.08.When the Q1 group was used as the reference,the Q3 group of HCT on the third day,the Q4 group of RBC and the first day.The HR values of the Q4 group minus the HCT difference on the third day were 7.38,1.51,and 0.48,respectively,and the differences were statistically significant(P<0.05).The AUC under the ROC curve of RBC and HCT on the third day of admission was 0.711 and 0.710;the AUC under the ROC curve of the first day after admission minus the HCT difference on the third day was 0.794.When the multi-factor adjusted,ROC curve of the AUC is 0.948.Conclusions:(1)High GCS score,high RBC and HCT on the third day of hospitalization are the main protective factors for the prognosis of hypertensive cerebral hemorrhage,the greater the difference in hematocrit between the first day and the third day of hospitalization,the higher the rate of poor prognosis after 3 months.(2)The prognostic model of hypertensive cerebral hemorrhage constructed by blood cell parameters has good sensitivity and specificity,and can be used as a predictive model for the prognosis of hypertensive cerebral hemorrhage.