Retrospective analysis of prognostic factors in HICH patients after neuroendoscopic hematoma evacuation

Abstract The objective of this study is to investigate key prognostic factors of clinical data and prognostic factors in patients with hypertensive intracerebral hemorrhage (HICH) who have undergone neuroendoscopic hematoma evacuation, specifically focusing on those with a hemorrhage volume of 20-40 mL, to identify the determinants influencing their prognosis. In this study, a total of 113 patients were ultimately included in the analysis. Variables such as age, preoperative Glasgow Coma Scale (GCS) scores, and hemorrhage locations were assessed. LASSO logistic regression was employed to select pertinent variables, which were then incorporated into a multivariate logistic regression model. The model’s performance was evaluated using ROC and calibration curves, along with clinical utility curves, and the recovery times of patients were analyzed using Kaplan–Meier curves, complemented by COX regression analysis. These three variables—Age (OR: 0.811; 95% CI 0.711–0.925), GCS score (OR: 25.923; 95% CI 4.108–163.598), and ICH location (OR: 7.345; 95% CI 1.811–29.783)—are strong predictors of intracerebral hemorrhage prognosis. Among the patients analyzed, 85.84% experienced a favorable prognosis. Younger age, higher preoperative GCS scores, and hemorrhages located in the basal ganglia and cerebral lobes were associated with better outcomes (mRS score of 0–3) . The nomogram, validated by an ROC curve analysis yielding an AUC of 0.9417 and the Hosmer–Lemeshow test, demonstrated accurate predictive and calibration capabilities for postoperative prognosis in patients with hypertensive intracerebral hemorrhage. Kaplan–Meier intervals and COX regression analysis indicated that age is a significant factor affecting the recovery time of these patients. Age, GCS score, and ICH location are significant prognostic factors for patients undergoing neuroendoscopic hematoma evacuation following hypertensive intracerebral hemorrhage, with age being a particularly important determinant of recovery time. Younger age, higher GCS scores, and lobar hemorrhage are associated with better prognosis.