Predicting hematoma growth in spontaneous intracerebral hemorrhage: A simplified non-contrast computed tomography based five-point grading approach

Table 1 The baseline demographics, clinical, imaging characteristics

Gender	Number (n)	Percentage (%)
Male	120	62.5
Female	72	37.5
Total	192	100
Male:female = 1.7:1
Comorbidity
Hypertension	150	78.1
Diabetes	74	38.5
Chronic kidney disease	66	35.1
Smoking	46	24
Dyslipidemia	38	19.8
Alcohol intake	6	3.1
Parameter
Capsuloganglionic	100	52.1
Lobar	70	36.5
Infratentorial	22	11.5
IVH
Present	108	56.3
Absent	84	43.8
SAH
Present	6	3.1
Absent	186	96.9
Baseline hematoma volume
< 30 mL	114	59.4
≥ 30 mL	78	40.6
Midline shift
Present	148	77.1
Absent	44	22.9
Island sign
Present	62	32.3
Absent	130	67.7
Swirl sign
Present	44	22.9
Absent	148	77.1
Black hole sign
Present	58	30.2
Absent	134	69.8

IVH: Intraventricular hemorrhage; SAH: Subarachnoid hemorrhage.

Table 2 Non-contrast computed tomography imaging characteristics of study population with and without hematoma expansion, n (%)

Variable	HE (n = 106, 55.2%)	Non-HE (n = 86, 44.8%)	P value
Baseline hematoma volume (mL), mean ± SD	44.1 ± 26.34	12.2 ± 16.32	< 0.001a
IVH	82 (77.4)	26 (30.2)	< 0.001a
SAH	4 (3.8)	2 (2.3)	0.685
Island sign	56 (52.8)	6 (7.0)	< 0.001a
Swirl sign	32 (30.2)	12 (14.0)	0.049a
Black hole sign	42 (39.6)	16 (18.6)	0.026a

^aP < 0.05.

HE: Hematoma expansion; IVH: Intraventricular hemorrhage; SAH: Subarachnoid hemorrhage.

Table 3 Imaging characteristics as per island sign, swirl sign, black hole sign

Variable	IS/SS/BS (+)	IS/SS/BS (-)	P value
Imaging characteristics as per island sign
Baseline hematoma volume (mL), mean ± SD	40.9 ± 27.03	24.5 ± 26.08	0.005a
HE, n (%)	56 (90.3)	50 (38.5)	< 0.001a
Imaging characteristics as per swirl sign
Baseline hematoma volume (mL), mean ± SD	37.9 ± 21.62	25.4 ± 23.97	0.031a
HE, n (%)	32 (72.7)	74 (50.0)	0.049a
Imaging characteristics as per black hole sign
Baseline hematoma volume (mL), mean ± SD	35.8 ± 21.98	26.1 ± 18.85	0.045a
HE, n (%)	42 (72.4)	64 (47.8)	0.026a

^aP < 0.05.

IS: Island sign; SS: Swirl sign; BS: Black hole sign; HE: Hematoma expansion.

Table 4 Multivariate logistic regression depicting predictors for hematoma expansion

Parameter	OR	95%CI	P value
Baseline hematoma volume ≥ 30 mL	1.9	1.41-2.74	0.039a
IVH	4.5	2.79-6.82	0.008a
Island sign	13.7	10.15-16.37	< 0.001a
Swirl sign	5.2	3.72-6.53	< 0.001a
Black hole sign	9.4	7.4-11.62	< 0.001a

^aP < 0.05.

OR: Odds ratio; CI: Confidence interval; IVH: Intraventricular hemorrhage.

Table 5 Summary of the hematoma expansion Prediction Grading System

Component	Points
Baseline hematoma volume (mL)
≥ 30	1
< 30	0
IVH
Present	1
Absent	0
Island sign
Present	1
Absent	0
Black hole sign
Present	1
Absent	0
Swirl sign
Present	1
Absent	0

IVH: Intraventricular hemorrhage.

Table 6 Risk of hematoma expansion according to the Prediction Grading System

Total score	No. of patients	HE	Risk of HE (%)
0	54	4	7.4
1	32	12	37.5
2	40	30	75.0
3	28	24	85.7
4	30	28	93.3
5	8	8	100

HE: Hematoma expansion.