Abstract / Summary
Background: To analyse the predictive value of serum oxidation-modified low-density lipoprotein (ox-LDL) and 25-hydroxyvitamin D [25-(OH)-D] levels before minimally invasive hematoma evacuation in patients with hypertensive intracerebral haemorrhage (H ICH) for cerebral oedema.
Methods: 300 patients with HICH in our hospital from August 2022 to August 2024 were selected as research subjects. Patients were divided into a high-ox-LDL group (ox-LDL 50 mg/dL) and a low-ox-LDL group (ox-LDL<50 mg/dL) according to their preoperative ox-LDL levels. The patients were separated into two groups based on the amount of serum 25-(OH)-D: high-level 25-(OH)-D (25-(OH)-D 30 ng/mL) and low-level 25-(OH)-D (25-(OH)-D<30 ng/mL). The incidence of cerebral oedema within 48 hours after surgery was compared among the groups. Following minimally invasive hematoma evacuation in patients with HICH, the predictive value of preoperative serum ox-LDL and 25-(OH)-D levels for cerebral oedema was evaluated using receiver operating characteristic (ROC) curves.
Results: The hematoma volume, fibrinogen level, and incidence of cerebral oedema varied significantly among patients with different serum ox-LDL and 25-(OH)-D levels (P< 0.05). The results of point-biserial correlation analysis revealed that the occurrence of cerebral oedema in HICH patients was positively correlated with the serum ox-LDL level (r= 0.455, P< 0.05) and negatively correlated with the serum 25-(OH)-D level (r= -0.534, P< 0.05). Pearson correlation analysis revealed a negative correlation between serum ox-LDL and 25-(OH)-D (r= -0.444, P< 0.05). The areas under the curve (AUCs) for preoperative serum ox-LDL, 25-(OH)-D alone, and combined detection in predicting cerebral oedema following minimally invasive hematoma evacuation in patients with HICH were 0.777, 0.768, and 0.839, respectively, according to ROC analysis. The AUC of combined detection was the largest.
Conclusions: Before minimally invasive hematoma evacuation in patients with HICH, the serum ox-LDL level was high, and the 25-(OH)-D level was low. Preoperative serum ox-LDL and 25-(OH)-D levels have high predictive value for cerebral oedema after minimally invasive hematoma evacuation in patients with HICH.