ORIGINAL RESEARCH article
Front. Neurol.
Sec. Neurological Biomarkers
HMOX1 mRNA Combined with Early Imaging Parameters for Predicting the Prognosis of Hypertensive Cerebral Hemorrhage Patients Undergoing Conservative Treatment
Provisionally accepted
- 1Department of Neurosurgery, Chun’an First People’s Hospital, Hangzhou Medical College Affiliated Chun’an Hospital, Hangzhou, China
- 2Department of Neurosurgery, Zhejiang Provincial People's Hospital, Affiliated People's Hospital, Hangzhou Medical College, Hangzhou, China
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Objective To address the limitations of current clinical tools in predicting the prognosis of hypertensive cerebral hemorrhage (HICH) patients undergoing conservative treatment, this study aimed to evaluate the predictive value of combining HMOX1 mRNA levels with early imaging parameters. Methods This retrospective diagnostic accuracy study involved 208 HICH patients (mean age 50 ± 9.5 years, 149 men) treated from December 2022 to December 2024. Patients were divided into good prognosis (mRS score ≤ 2, n = 112) and poor prognosis (mRS score > 2, n = 96) groups based on 90-day mRS scores. The index tests were HMOX1 mRNA levels and early imaging parameters (hemorrhage location, hematoma volume, and shape), with the reference standard being the 90-day mRS score. Statistical analyses included hierarchical regression, multivariate logistic regression, and ROC curve evaluations. Bootstrap resampling (1000 samples) confirmed that the OR values of key risk factors were stable Results HMOX1 mRNA expression was higher in the poor prognosis group (1.36 ± 0.41 vs. 1.00 ± 0.22, p < 0.001). Delong test showed that the AUC of the combination of HMOX1 mRNA and imaging parameters (0.871, 95% CI: 0.818-0.924) was significantly higher than that of single indicators (all P<0.05). A nomogram model incorporating these factors plus clinical and laboratory indicators showed good discrimination (C-index: 0.814) and calibration (AUC: 0.94), and its AUC was significantly higher than that of the above combined indicator (P=0.003). Conclusion The 'HMOX1 mRNA + imaging parameters' combined indicator and the nomogram model both significantly improve prognostic prediction accuracy in HICH patients undergoing conservative treatment, with the nomogram model showing the best efficiency.
Keywords: Hypertensive cerebral hemorrhage, HMOX1, Imaging parameters, prognosis, Nomogram model
Received: 01 Jul 2025; Accepted: 21 Oct 2025.
Copyright: © 2025 Dong, Ye, Wang, Ye and Peng. 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: Deqing Peng, pengdeqing@hmc.edu.cn
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