Admission-time prediction of 7-day mortality in clinician-attributed hypertensive intracerebral hemorrhage: development and external validation against the ICH score
Abstract
Early mortality after intracerebral haemorrhage remains difficult to estimate at admission. We developed models for recorded mortality within 7 days after admission in two retrospective cohorts of clinician-attributed hypertensive intracerebral haemorrhage. Qingyuan records (n = 1,433; 369 events) were used for grouped nested cross-validation, and Yunfu records (n = 924; 182 events) for external validation. The models used 28 admission-time predictors. Predictions were averaged across 20 imputation-specific pipelines. Elastic-net logistic regression was selected from the development data. Its development and external areas under the receiver operating characteristic curve were 0.848 and 0.893, respectively. In external validation, the ICH score had an area under the curve of 0.860, giving a difference of 0.0324 (95% CI 0.0126–0.0523; DeLong P = 0.00135). The external Brier score was 0.103, with a calibration intercept of − 0.504 and slope of 1.149. At the development-selected threshold of 0.1976, sensitivity was 0.901 and specificity was 0.706. The model modestly improved discrimination over the ICH score, but overprediction, differences between centres, and unavailable treatment and outcome-ascertainment details limit clinical interpretation.
Related
- A multimodal Vision-Mamba model based on non-contrast CT hematoma and shell features predicts early hematoma expansion in hypertensive intracerebral hemorrhage: a multicenter study
- Development and Validation of a Human Cadaveric Model for Lobar Intracerebral Hemorrhage
- Regional prediction of hematoma expansion from non-contrast computed tomography in spontaneous intracerebral hemorrhage patients
- A novel postpartum hemorrhage prediction model for women with hypertensive disorders of pregnancy in secondary hospitals of middle-income settings
- Development and Cross-Database External Validation of 24-Hour Landmark Models for ICU Mortality After Intracerebral Hemorrhage: Incremental Value of Routine Coagulation Markers
BibTeX
@article{chen2026admissiontime,
title = {{Admission-time prediction of 7-day mortality in clinician-attributed hypertensive intracerebral hemorrhage: development and external validation against the ICH score}},
author = {Qingwen Chen and Tao Zhong and Jian Liu and Dawei Feng and Han Gao},
journal = {Scientific Reports},
year = {2026},
month = oct,
doi = {10.1038/s41598-026-75371-w},
url = {https://www.nature.com/articles/s41598-026-75371-w},
note = {CC BY-NC-ND 4.0},
}
RIS
TY - JOUR
TI - Admission-time prediction of 7-day mortality in clinician-attributed hypertensive intracerebral hemorrhage: development and external validation against the ICH score
AU - Qingwen Chen
AU - Tao Zhong
AU - Jian Liu
AU - Dawei Feng
AU - Han Gao
PY - 2026
DA - 2026/10/14
JO - Scientific Reports
DO - 10.1038/s41598-026-75371-w
UR - https://www.nature.com/articles/s41598-026-75371-w
AB - Early mortality after intracerebral haemorrhage remains difficult to estimate at admission. We developed models for recorded mortality within 7 days after admission in two retrospective cohorts of clinician-attributed hypertensive intracerebral haemorrhage. Qingyuan records (n = 1,433; 369 events) were used for grouped nested cross-validation, and Yunfu records (n = 924; 182 events) for external validation. The models used 28 admission-time predictors. Predictions were averaged across 20 imputation-specific pipelines. Elastic-net logistic regression was selected from the development data. Its development and external areas under the receiver operating characteristic curve were 0.848 and 0.893, respectively. In external validation, the ICH score had an area under the curve of 0.860, giving a difference of 0.0324 (95% CI 0.0126–0.0523; DeLong P = 0.00135). The external Brier score was 0.103, with a calibration intercept of − 0.504 and slope of 1.149. At the development-selected threshold of 0.1976, sensitivity was 0.901 and specificity was 0.706. The model modestly improved discrimination over the ICH score, but overprediction, differences between centres, and unavailable treatment and outcome-ascertainment details limit clinical interpretation.
SN - 2045-2322
ER -