ABSTRACT NUMBER: ESOC2026A869 COMBINED BIOCHEMICAL AND RADIOLOGICAL MARKERS FOR EARLY PREDICTION OF HEMATOMA EXPANSION IN SPONTANEOUS INTRACEREBRAL HEMORRHAGE

Abstract Background and aims sICH has high morbidity and mortality, mainly from early hematoma expansion (HE). This study evaluated serum calcium, blood glucose, and CT markers as predictors of HE to support timely clinical decision-making. Methods This retrospective study included 512 sICH patients admitted to Al-Azhar University and Cairo Fatemia Hospitals from April 2022 to 2025. Patients were divided into HE (n = 218, 42.6%) and non-HE (n = 294, 57.4%) groups. Logistic regression identified independent predictors of HE, and ROC analysis evaluated the predictive performance of serum calcium, blood glucose, and CT signs, both individually and in a combined model. Results Patients who developed HE had lower serum calcium (1.95 ± 0.28 mmol/L) and higher blood glucose (8.21 ± 2.17 mmol/L) than those without HE (2.36 ± 0.31 mmol/L and 6.42 ± 1.89 mmol/L, P < 0.001). Hypocalcemia (≤2.24 mmol/L), hyperglycemia (≥7.96 mmol/L), and expansion-prone CT signs independently predicted HE. The combined model showed excellent accuracy (AUC 0.96, sensitivity 97.8%, specificity 98.1%), enabling early risk stratification in sICH. Conclusions A combined model incorporating hypocalcemia, hyperglycemia, and CT imaging markers significantly enhances the prediction of early hematoma expansion in spontaneous intracerebral hemorrhage. This integrated approach may support early clinical decision-making, improve risk stratification, and guide personalized therapeutic strategies in patients with sICH. Conflict of interest Nothing to disclose