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Research Article | Open Access

Ultra-early hematoma growth predicts gastrointestinal bleeding after spontaneous intracerebral hemorrhage

Yan Fua,1Xiao Hua,1Xiao-San Wua,1Lei ZhuaMeng-Qiu ZhangaYun-He XiaaFang-Jian ZhuaZi-Jie WangaChuan-Qin Fanga( )Qi Lia,b( )
Department of Neurology, The Second Affiliated Hospital of Anhui Medical University, Hefei, Anhui 230601, China
Department of Neurology, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China

1 These authors contributed equally to this work.

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Abstract

Objective

Ultra-early hematoma growth (uHG) has been shown to predict hematoma expansion (HE) and poor outcomes in intracerebral hemorrhage (ICH) patients. Gastrointestinal bleeding, a severe ICH complication, has been found to correlate with hematoma volumes. This study analyzes the correlation between uHG and the risk of post-ICH gastrointestinal bleeding.

Method

We prospectively recruited consecutive ICH patients. uHG was identified as the hematoma volume on the baseline computed tomography (CT) scan, divided by time from onset to CT (ml/h). Univariate and multivariate logistic regression models identified risk factors for gastrointestinal bleeding. Predictive models were formulated and evaluated using receiver operating characteristic (ROC) curves.

Results

Our study involved 138 patients, and 52 (37.7 %) had gastrointestinal bleeding after ICH. Multivariate analysis revealed uHG (aOR: 1.061; 95 % CI: 1.002–1.123; p = 0.041) as an independent predictor of gastrointestinal bleeding in ICH patients. uHG also correlated significantly with 90-day outcomes (aOR: 1.109; 95 % CI: 1.012–1.215; p = 0.026). ROC analysis showed the uHG − incorporated predictive model had strong predictive power for gastrointestinal bleeding.

Conclusion

uHG was linked to higher risks of gastrointestinal bleeding and 90-day poor outcomes among primary ICH patients.

References

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Brain Hemorrhages
Pages 206-211

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Cite this article:
Fu Y, Hu X, Wu X-S, et al. Ultra-early hematoma growth predicts gastrointestinal bleeding after spontaneous intracerebral hemorrhage. Brain Hemorrhages, 2025, 6(5): 206-211. https://doi.org/10.1016/j.hest.2025.07.001

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Received: 27 April 2025
Revised: 27 May 2025
Accepted: 01 July 2025
Published: 03 July 2025
© 2025 International Hemorrhagic Stroke Association.

This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).