Correlation between serum lipid level and hematoma enlargement in patients with acute intracerebral hemorrhage

Objective To investigate the correlation between baseline serum lipid levels and hematoma enlargement in patients with acute intracerebral hemorrhage (ICH). Methods From October 2013 to January 2018, patients with ICH admitted to the Department of Neurosurgery, Heze Municipal Hospital, were enrolled retrospectively. The first CT scan was completed within 6 h after onset, and the second one was completed at 48 h after onset. Hematoma enlargement was defined as an increase >33% in the volume of hematoma on CT. The demographic and baseline clinical data in the hematoma enlargement group and the non-hematoma enlargement group were compared. Multivariate logistic regression analysis was used to identify the independent risk factors for hematoma enlargement. Results A total of 470 patients with acute ICH were enrolled, including 187 females (39.8%) and 283 males (60.2%), aged 47-81 years. Seventy-nine patients (16.8%) had hematoma enlargement. The proportion of patients with atrial fibrillation and who used warfarin before onset, as well as age, baseline National Institutes of Health Stroke Scale score, baseline hematoma volume, international normalized ratio, prothrombin time, activated partial thromboplastin time, and thrombin time of the hematoma enlargement group were significantly higher than those of the non-hematoma enlargement group (all P<0.05), while from the onset to the first CT scan time, total cholesterol, triglyceride, low-density lipoprotein cholesterol levels were significantly lower than those in the non-hematoma enlargement group (all P<0.05). Multivariate logistic regression analysis showed that baseline total cholesterol <3.20 mmol/L (odds ratio [OR] 1.32, 95% confidence interval [CI] 1.08-1.83; P=0.004), baseline hematoma volume ≥30 ml (1.76, 95% CI 1.30-2.15; P<0.001), and using anticoagulant before onset (OR 2.37, 95% CI 1.81-3.02; P<0.001) had significantly independent correlation with hematoma enlargement. Conclusion Baseline total cholesterol <3.20 mmol/L, hematoma volume ≥30 ml, and using anticoagulant before onset were the independent risk factors for hematoma enlargement in patients with acute ICH. Key words: Cerebral Hemorrhage; Cholesterol; Hematoma; Tomography, X-Ray Computed; Time Factors; Biomarkers; Risk Factors