ABSTRACT NUMBER: ESOC2026A1696 IMPACT OF HEMATOMA VOLUME AND LOCALIZATION ON CLINICAL PROGNOSIS IN INTRACEREBRAL HEMORRHAGE

Abstract Background and aims To assess the effect of hematoma volume and location on in-hospital mortality, severe disability (mRS), and short-term outcomes in hemorrhagic stroke. Methods Clinical and radiological data from 100 patients with hemorrhagic stroke (mean age 61 ± 6.8 years; 65% male) were analyzed. All underwent CT or MRI within 24 hours of symptom onset. Hematoma volume (HV) was calculated using the ABC/2 method and classified as <30 mL (n = 81) or ≥30 mL (n = 19). Hematoma location was categorized as lobar (most frequent), thalamic, basal ganglia, brainstem, or cerebellar. Outcomes were evaluated using the mRS and in-hospital mortality. Statistical analysis included odds ratios (OR), 95% confidence intervals (CI), and ROC–AUC. Results Patients with hematoma volume ≥ 30 mL had a significantly higher risk of mortality (OR = 5.2; 95% CI: 1.8–15.0; p = 0.003). Poor prognosis was most commonly observed in brainstem and thalamic hemorrhages, with an increased risk of severe functional disability (OR = 3.8; 95% CI: 1.4–10.2; p = 0.008). ROC analysis of the prognostic model incorporating hematoma volume and localization yielded an AUC of 0.82, indicating good predictive performance. Overall in-hospital mortality was 13% (n = 13), including 9% (n = 9) in the HV ≥ 30 mL group and 4% (n = 4) in the HV < 30 mL group. Conclusions Hematoma volume and anatomical localization identified by CT/MRI are independent and key determinants of early clinical prognosis in hemorrhagic stroke. Incorporation of these parameters is essential for selecting optimal intensive treatment strategies. Conflict of interest nothing to disclose