Clinical, Laboratory, and Radiological Predictors of 30-Day Mortality in Patients with Spontaneous Intracerebral Hemorrhage

Abstract

Objective: This study retrospectively evaluated the clinical, laboratory, and radiological predictors of 30-day mortality in patients with spontaneous intracerebral hemorrhage(ICH), along with the discriminative power of various inflammatory and prognostic indices. Materials and Methods: Between January 2022 and December 2024, the demographic characteristics, vital signs, laboratory parameters, and imaging findings of 150 patients who presented to the emergency department with spontaneous ICH and had accessible 30-day mortality data were retrospectively analyzed. Inflammatory indices including the neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), lymphocyte-to-monocyte ratio (LMR), HALP score, systemic inflammation response index (SIRI), and glucose-to-lymphocyte ratio were calculated. Patients were stratified according to 30-day survival status, and intergroup comparisons were performed. The predictive performance of these indices was assessed ROC curve analysis. Results: A total of 47.3% of the patients died within 30 days. Low Glasgow Coma Scale(GCS) , large hematoma volume, presence of intraventricular hemorrhage(IVH), midline shift, need for intubation, and elevated blood pressure were all significantly associated with mortality (all p < 0.001). Hematoma volume had the highest area under the ROC curve (AUROC = 0.897; 95% CI: 0.847–0.947). The HALP score was significantly lower in non-survivors, while NLR, PLR, SIRI, and the glucose-to-lymphocyte ratio were significantly higher in this group (all p < 0.001). NLR demonstrated particularly high specificity (88.6%) for predicting mortality. Conclusion: Hematoma volume is the best way to predict mortality in spontaneous ICH. Simple inflammatory indices such as NLR, HALP and SIRI can also help with early risk stratification.

Keywords

• Intracerebral hemorrhage
• Mortality
• Hematoma volume
• HALP score
• Neutrophil-to-lymphocyte ratio
• Glasgow Coma Scale

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