Prediction of short-term prognosis of patients with hypertensive intracerebral hemorrhage by radiomic-clinical nomogram

Abstract

Hypertensive intracerebral hemorrhage (HICH) is the most common type of spontaneous intracerebral hemorrhage in China which is associated with high mortality and disability. We sought to develop and validate a noncontrast computed tomography (NCCT)-based nomogram model to achieve short-term prognostic prediction for patients with HICH. We retrospectively studied 292 patients with HICH from two medical centers, and they were divided into training (n = 151), validation (n = 66), and testing cohorts (n = 75). Based on radiomics, univariate and multivariate, and logistic regression analyses, four models (black hole sign, clinical, radiomics score, and combined models) were established to predict the prognosis of patients with HICH 30 days after the onset. The results suggested that the combined model had the best predictive performance with the area under the receiver operating characteristic curve (AUC) of 0.821, 0.816, and 0.815 in the training, validation, and testing cohorts, respectively. In addition, a radiomics-clinical (R-C) nomogram was visualized. A calibration curve analysis showed that the R-C nomogram had satisfactory calibration in the three cohorts. A decision curve analysis demonstrated that the R-C nomogram was clinically valuable. Our results suggest that the R-C nomogram can accurately and reliably predict the short-term prognosis of patients with HICH and provide a useful evaluation for making individualized treatment plans.

Predicting postoperative rehemorrhage in hypertensive intracerebral hemorrhage using noncontrast CT radiomics and clinical data with an interpretable machine learning approach

“…HICH, recognized as the most lethal cerebrovascular condition and a subtype of sICH 5 , poses significant treatment challenges. Emergency interventions like craniotomy are effective in reducing mortality by decreasing intracranial pressure and the size of the hematoma 7 , 8 .…”

“…A common and severe complication of hypertension is hypertensive intracerebral hemorrhage (HICH), characterized by its sudden onset, rapid progression, and associated complications 3 , 4 . HICH, a subtype of spontaneous intracerebral hemorrhage (sICH), has the highest mortality rate among cerebrovascular diseases 5 . HICH accounts for about 30% of stroke incidences 6 .…”

“…This method's integration into medical diagnostics has proven invaluable across various fields, including but not limited to oncology and cardiology 19 – 21 . Recent advancements further highlight its effectiveness in non-invasively predicting outcomes for patients with HICH, showcasing its broad applicability and potential in medical prognostication 5 , 22 , 23 . However, the complex and frequently nonlinear connections between the myriad subtle features identified by radiomics and their clinical outcomes pose a substantial analytical challenge.…”

Intracerebral Hemorrhage in Renal Compromised State: How is the Combination?

“…The study has beautifully showed a difference in outcome between renal compromised patients and patients with normal renal function who have suffered acute ICH. [ 6 ]…”