title: Prognostic value of perihematomal edema area at the initial ED presentation in patients with intracranial hematoma.
abstract: OBJECTIVE
  Intracerebral hemorrhage (ICH) is a potentially life-threatening condition. Interventions and treatments should be managed on time to reduce mortality. It has been put forth that perihematomal edema absolute volume (PHEAV) is related to mortality, however the effect of perihematomal edema absolute area (PHEAA) on mortality is unknown. The objective of this study was to evaluate the effect of PHEAA on 30-day mortality in patients with ICH.
  
  
  METHODS
  Patients were screened with ICD-9, retrospectively. 106 patients were included in the study. Clinical data were obtained from the patient files. Computed tomography (CT) was acquired from the hospital imaging database. PHEAV and PHEAA were measured via CT by two clinicians blinded to the study protocol. The predictors of 30- day mortality were examined.
  
  
  RESULTS
  Forty-three (40.6%) patients died within 30days. Older age, lack of trauma, low Glasgow coma scale and high blood glucose were associated with high mortality (P≤.001). PHEAV and PHEAA values were higher in nonsurvivors (P<.001). PHEAA was detected as an independent predictor of 30-day mortality. The cutoff value of PHEAA for mortality was 33.41cm(2) (sensitivity: 84.4%, specificity: 59.0%). There was no difference between receiver operating characteristic curves of PHEAA and PHEAV (P=.55).
  
  
  CONCLUSIONS
  In contrast to PHEAV, PHEAA is a simple value which can be measured without the requirement of any additional techniques or extra costs which can be quickly applied and which is an independent indicator of 30-day mortality. PHEAA can accelerate physician interventions for patients with ICH within several hours of ED admission.
authors.affiliation: Afyon Kocatepe University, School of Medicine, Department of Emergency Medicine, Afyonkarahisar, Turkey. Electronic address: drseri03@hotmail.com.
authors.forename: Serife
authors.initials: S
authors.lastname: Ozdinc
authors.affiliation: Afyon Kocatepe University, School of Medicine, Department of Radiology, Afyonkarahisar, Turkey. Electronic address: eunlu@gmail.com.
authors.forename: Ebru
authors.initials: E
authors.lastname: Unlu
authors.affiliation: İzmir Katip Celebi University, Atatürk Training and Research Hospital, Clinic of Emergency Medicine, Izmir, Turkey. Electronic address: zkarakaya@gmail.com.
authors.forename: Zeynep
authors.initials: Z
authors.lastname: Karakaya
authors.affiliation: Afyon Kocatepe University, School of Medicine, Department of Anatomy, Afyonkarahisar, Turkey. Electronic address: ozantrmnlr@gmail.com.
authors.forename: Ozan
authors.initials: O
authors.lastname: Turamanlar
authors.affiliation: Afyon Kocatepe University, School of Medicine, Department of Biostatistics and Medical Informatics, Afyonkarahisar, Turkey. Electronic address: nurhandogan@hotmail.com.
authors.forename: Nurhan
authors.initials: N
authors.lastname: Dogan
authors.affiliation: Bursa Yuksek Ihtisas Training and Research Hospital, Clinic of Emergency Medicine, Bursa, Turkey. Electronic address: dryesim77@yahoo.com.
authors.forename: Yesim
authors.initials: Y
authors.lastname: Isler
authors.affiliation: Afyon Kocatepe University, School of Medicine, Department of Anatomy, Afyonkarahisar, Turkey. Electronic address: yucel94@hotmail.com.
authors.forename: Yucel
authors.initials: Y
authors.lastname: Gonul
authors.affiliation: Afyon Kocatepe University, School of Medicine, Department of Neurosurgery, Afyonkarahisar, Turkey. Electronic address: drmgzbyc@hotmail.com.
authors.forename: Mehmet Gazi
authors.initials: MG
authors.lastname: Boyaci
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001929:Brain Edema / Q000000981:diagnostic imaging* / Q000209:etiology / Q000401:mortality; D002543:Cerebral Hemorrhage / Q000150:complications / Q000000981:diagnostic imaging* / Q000401:mortality*; D004636:Emergency Service, Hospital; D005260:Female; D015600:Glasgow Coma Scale; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed