Admission Serum Calcium Level And Hematoma Expansion In Patients With Intracerebral Hemorrhage In QingHai Region

Objective:Hematoma Expansion which occurs in one third of patients with intracerebral hemorrhage at early stage.and the purpose of this study is to investigate the relationship between admission serum Calcium levels and hematoma expansion in patients with intracerebral hemorrhage in Qing Hai district.Methods:A total of 222 patients,who were diagnosed with spontaneous intracerebral hemorrhage（ICH）by CT scans and doctors’clinical experience in Qing Hai provincial people’s hospital from 2018 to 2019,were subsequently admitted in our study cohort.These patients underwent the first and followed CT scans within 12 and 24hours of intracerebral hemorrhage onset respectively,and 3D slicer software was used to quantify the volume of hematoma so that to further evaluate HE（defined as an increase of more than 30%or 6 m L from baseline ICH volume）.Upon these patients’admissioin,the data of serum Ca2+levels were also collected.Based on admission serum Ca2+level and whether or not the hematoma expansion,patients were classified into three groups Q1、Q2、Q3（Q1≤[2.2],Q2[2.2-2.7],Q3[≧2.7]mmol/L）and HE（+）、HE（-）subgroups.Demographic,clinical,radiographic and outcome data were evaluated using univariate and multivariate logistical regression models.Result:Hematoa expansion（HE）occurred in 25.68%（57/222）of 222 patients with supratentorial spontaneous intracerebral hemorrhage.The admission serum Ca2+level in HE（+）group was significantly lower than that in HE（-）group（2.18±0.23 vs2.43±0.28 mmol/L;P<0.001）.Moreover,HE（+）group had lower admission serum Mg2+level,larger initial hematoma volume（V₀）and lower admission GCS score（P<0.05）.For Q1、Q2、Q3 group comparisons,Q1 group had larger initial hematoma volume（Q1:44.41±21.47 vs Q2:27.72Q1:44.41±21.20 vs Q3:17.87Q1:44.41±11.56;F=31.516,P<0.001）and lower admission GCS score（χ²=18.626,P=0.001）.Conclusion:Admission serum Ca²⁺level in patients with spontaneous intracerebral hemorrhage were Confirmed associated with early hematoma expansion,larger initial hematoma volume,and lower admission GCS scores.So admission serum Ca2+level might be a Warning signal for HE.Of course,the results of this study need to be further confirmed by large sample multi-center prospective experimental studies.