Hematological indices as predictors of intracerebral hematoma expansion detected on serial computed tomography

Abstract

Objective: Hematoma expansion is associated with unfavourable neurological outcomes in intracranial haemorrhage. We aimed to study association of red blood cell (RBC) indices, platelet indices, and their ratios with hematoma expansion, detected by serial computed tomography (CT). Methods: Hospital-based observational study of 88 patients with intracerebral hematoma referred for serial CT head with patients grouped as having progression/ no change/ resolution of hematoma. Baseline hematological indices and ratios were analysed. Results: 40 patients (45.5 %) had resolution, 20 patients (22.7 %) had no change and 28 patients (31.8 %) had progression of hematoma. RBC distribution width (RDW) (p value 0.001) and Plateletcrit (p-value 0.009) showed statistically significant difference among the groups. RBC distribution width (RDW) to PC ratio (RPR) showed statistically significant increase (p 0.0615 had greater chances of hematoma progression {OR 3.1 (95 % CI 1.22 to 7.91); p = 0.0174} Conclusion: Raised RPR was most significant parameter with higher RDW, lower plateletcrit values in patients with progression of intra-parenchymal hematoma. These readily available indices can aid in prompt prognostication of intracerebral haemorrhage cases.

Keywords

• Hematoma expansion
• Red blood cell indices
• Platelet indices
• CT scan