Development and external validation of a novel multihematoma fuzzy sign on computed tomography for predicting traumatic intraparenchymal hematoma expansion

Author:

Sheng Jiangtao,Yang Jinhua,Cai Shirong,Zhuang Dongzhou,Li Tian,Chen Xiaoxuan,Wang Gefei,Dai Jianping,Ding Faxiu,Tian Lu,Zheng Fengqing,Tian Fei,Huang Mindong,Li Kangsheng,Chen Weiqiang

Abstract

AbstractAcute traumatic intraparenchymal hematoma (tICH) expansion is a devastating neurological complication that is associated with poor outcome after cerebral contusion. This study aimed to develop and validate a novel noncontrast computed tomography (CT) (NCCT) multihematoma fuzzy sign to predict acute tICH expansion. In this multicenter, prospective cohort study, multihematoma fuzzy signs on baseline CT were found in 212 (43.89%) of total 482 patients. Patients with the multihematoma fuzzy sign had a higher frequency of tICH expansion than those without (90.79% (138) vs. 46.71% (71)). The presence of multihematoma fuzzy sign was associated with increased risk for acute tICH expansion in entire cohort (odds ratio [OR]: 16.15; 95% confidence interval (CI) 8.85–29.47; P < 0.001) and in the cohort after propensity-score matching (OR: 9.37; 95% CI 4.52–19.43; P < 0.001). Receiver operating characteristic analysis indicated a better discriminative ability of the presence of multihematoma fuzzy sign for acute tICH expansion (AUC = 0.79; 95% CI 0.76–0.83), as was also observed in an external validation cohort (AUC = 0.76; 95% CI 0.67–0.84). The novel NCCT marker of multihematoma fuzzy sign could be easily identified on baseline CT and is an easy-to-use predictive tool for tICH expansion in the early stage of cerebral contusion.

Funder

China Postdoctoral Science Foundation

National Natural Science Foundation of China

Medical Scientific Research Foundation of Guangdong Province

Clinical Improvement Program of Shantou University Medical College

Top-tier University Development Scheme for Research and Control of Infectious Diseases

Natural Science Foundation of Guangdong Province

Publisher

Springer Science and Business Media LLC

Subject

Multidisciplinary

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