Development and validation of a predictive model for postoperative functional recovery in patients with spontaneous intracerebral hemorrhage
Year: 2025
Type: article
Study design: Observational Study
Abstract: Background: This study aimed to develop and validate a prognostic nomogram for predicting 3-month functional recovery in patients undergoing surgery for spontaneous intracerebral hemorrhage (ICH). Methods: = 86, 30%). A prognostic nomogram integrating imaging characteristics and clinical parameters was developed to predict 90-day functional recovery (modified Rankin Scale ≤2). Feature selection employed the Boruta algorithm, followed by multivariable logistic regression. Model discrimination was quantified by area under the ROC curve (AUC), while calibration curve was performed to evaluate model performance. Clinical utility was evaluated through decision curve analysis (DCA). Results: The multivariable model retained six significant predictors: midline shift (OR:2.09, 95%CI: 1.56-2.79), hematoma volume (OR:1.10, 95%CI: 1.05-1.15), age (OR:1.03, 95%CI: 1.01-1.05), mean arterial pressure (OR:0.93, 95%CI: 0.89-0.98), body mass index (OR:0.78, 95%CI: 0.66-0.92), and Glasgow Coma Scale (GCS) score (OR:0.92, 95%CI: 0.79-1.06). Discriminative performance was robust, with area under the receiver operating characteristic curve (AUC) of 0.90 (95% CI: 0.85-0.96) in the training set and 0.83 (95% CI: 0.73-0.93) in the validation set. Calibration plots demonstrated excellent agreement between predicted and observed probabilities. DCA confirmed the clinical value of the model and its good impact on actual decision-making. Conclusion: This study developed and validated a pragmatic prognostic nomogram for spontaneous ICH patients undergoing surgical intervention, integrating six clinically actionable predictors: midline shift, hematoma volume, age, MAP, BMI, and GCS. The model demonstrated robust discriminative capacity, calibration and clinical applicability, which provides evidence-based support for the formulation of individualized rehabilitation programs and the optimization of medical resources.
Source: Frontiers in Surgery
Authors: Ziming Jiang, Ruijuan Zhang, Danfeng Weng, Yuhang Lv, Liang Dong
Institution: Taizhou Central Hospital
Language: English
Subfield: Neurology
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $3,801
OpenAlex ID: W4415303624