ORIGINAL RESEARCH article
Front. Hum. Neurosci.
Sec. Brain Health and Clinical Neuroscience
This article is part of the Research TopicAlterations in brain structure and cognitive function caused by cerebrovascular diseases Volume IIView all 5 articles
Low Perioperative Hemoglobin as an Independent Detrimental Predictor of Functional Outcome After Basal Ganglia Hemorrhage: Development and Validation of a Composite Prognostic Model
Provisionally accepted
- 1The Affiliated Hospital of Qingdao University, Qingdao, China
- 2Qingdao Central Hospital of University of Health and Rehabilitation Sciences, Qingdao, China
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Background: Basal ganglia hemorrhage (BGH) is a life-threatening neurosurgical emergency associated with substantial mortality and disability. Accurate postoperative prognosis assessment remains challenging due to multifactorial influences. Hemoglobin (HB), as the key determinant of oxygen delivery, may play a critical role in neurological recovery, yet the prognostic significance of perioperative HB fluctuations in BGH has not been fully elucidated. Methods: A retrospective cohort of 213 surgically treated BGH patients from 2020 to 2023 was analyzed. Perioperative HB indices, including preoperative (Pre-HB), postoperative (Post-HB), and mean HB (Mean-HB) levels, were evaluated alongside clinical data. Functional outcome at six months was determined based on the modified Rankin Scale (mRS). LASSO regression together with multivariate logistic regression models were utilized to screen for independent risk variables, followed by construction of a composite predictive model. Model discrimination, calibration, and evaluation of the model’s clinical applicability were conducted using receiver operating characteristic (ROC) analysis, calibration plots, and decision curve analysis (DCA). Results: Patients with poor prognosis exhibited significantly lower Pre-HB, Post-HB, and Mean-HB levels (all P < 0.05). Multivariate analysis confirmed these variables as independent predictors of adverse outcome. The proposed model provides a practical and data-driven tool that demonstrated good predictive performance (AUC = 0.84) in a single-center retrospective cohort. Calibration and DCA demonstrated good consistency and potential clinical applicability. Conclusion: Perioperative declines in HB are independently associated with poor postoperative outcomes in BGH. The proposed HB-integrated model provides a reliable, dynamic tool for individualized risk prediction, facilitating precision perioperative management and optimized recovery strategies.
Keywords: Basal Ganglia Hemorrhage, Hemoglobin, Perioperative management, predictive model, prognosis
Received: 12 Nov 2025; Accepted: 08 Dec 2025.
Copyright: © 2025 Li, Zhang, Yang, Ding, Yu, Yang, Duan and Dong. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Yi Dong
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