Relationship between coagulation function and long-term prognosis of patients with hypertensive intracerebral hemorrhage during acute stage

SU Yan'e; FENG Feixue; ZHOU Jiadi; HU Weimin; WANG Jin; ZHANG Yi; LIU Yifei

Abstract：Objective To explore the relationship between coagulation function and long-term prognosis of patients with hypertensive intracerebral hemorrhage(HICH)during acute stage.Methods In the prospective cohort study,126 patients with HICH confirmed in the hospital between September 2021 and September 2023 were enrolled.According to scores of modified National Institutes of Health Stroke Scale(mNIHSS),they were divided into mild group(n=48),moderate group(n=46)and severe group(n=32),and coagulation function indexes in the three groups were compared.The correlation between mNIHSS scores and coagulation function indexes was analyzed by Pearson correlation analysis.According to scores of modified Rankin scale(mRS)after 1 year of follow-up,patients were divided into good prognosis group(≤2 points,n=88)and poor prognosis group(＞2 points,n=38),and coagulation function indexes in the two groups were compared.The predictive value of coagulation function indexes for poor long-term prognosis of HICH patients was analyzed by receiver operating characteristic(ROC)curves.Results In the severe group and the moderate group,activated partial thromboplastin time(APTT),prothrombin time(PT),thrombin time(TT),fibrinogen(FIB)and D-dimer(DD)gradually decreased(P＜0.05).Pearson correlation analysis showed that mNIHSS score was positively correlated with APTT,TT,PT,FIB and DD(r=0.381,0.359,0.370,0.423,0.414,P＜0.05).APTT,TT,PT,FIB and DD in poor prognosis group were higher than those in good prognosis group(P＜0.05).ROC curves analysis showed that AUC,sensitivity and specificity of APTT,TT,PT,FIB,DD and combined detection for predicting poor long-term prognosis of HICH patients during acute stage were(0.713,0.629,0.707,0.751,0.732,0.818),(77.27%,70.45%,73.86%,81.82%,79.55%,96.40%)and(71.05%,68.42%,71.05%,76.32%,73.68%,65.79%)respectively(P＜0.05).Conclusions There are significant differences in coagulation function levels among patients with different severity of HICH during acute stage.The changes of coagulation function are related to poor long-term prognosis,and combined detection has good predictive value for poor long-term prognosis.