Combined application of the modified early warning score and the modified hematoma expansion prediction score for predicting hematoma expansion in intracerebral hemorrhage

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This study aimed to evaluate the predictive value of the combined Modified Early Warning Score (MEWS) and Modified Hematoma Expansion Prediction (MHEP) score for hematoma expansion(HE)in patients with intracerebral hemorrhage (ICH). The goal was to provide an accurate and practical tool for risk assessment in this patient population. Clinical data from patients with ICH admitted to Nanchuan Hospital Affiliated to Chongqing Medical University between January 2024 and June 2025 were prospectively collected. Univariate and multivariate logistic regression analyses were conducted to identify factors associated with HE. Subsequently, the predictive performance of the combined MEWS and MHEP scores (termed MEWS-MHEP) was evaluated using receiver operating characteristic (ROC) curve analysis. A total of 421 patients were enrolled and categorized into the hematoma expansion group (n = 58) and the non-hematoma expansion group (n = 363). Significant differences (P < 0.05) were observed in smoking history, alcohol consumption, hematoma location, hematoma volume, island sign, and Glasgow Coma Scale (GCS) score, indicating their association with HE. The MEWS showed a moderate correlation with HE (P = 0.004). Both the MHEP score and the combined MEWS-MHEP score were significantly higher in the HE group (P < 0.001). The MEWS-MHEP score yielded an AUC of 0.813, which was significantly higher than that of the MEWS alone (0.616) and the MHEP score alone (0.699) (P < 0.001), with an overall prediction accuracy of 80.76%.The MEWS-MHEP score outperforms either the MEWS or MHEP score alone in predicting HE in patients with ICH. Thus, it represents a reliable tool for emergency risk stratification and may aid in optimizing medical resource allocation.

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