{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,7]],"date-time":"2026-09-07T06:08:02Z","timestamp":1788761282894,"version":"build-2803163510"},"reference-count":35,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,9,7]],"date-time":"2026-09-07T00:00:00Z","timestamp":1788739200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Neurol."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Women are at a higher risk of poor outcomes following spontaneous intracerebral hemorrhage (ICH) compared to men, necessitating closer clinical monitoring. Preventing hematoma expansion (HE) represents a promising therapeutic target in the management of spontaneous ICH. This study aimed to develop a clinically practical decision tree model to predict HE in women.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We retrospectively reviewed women with spontaneous ICH. All patients underwent initial and follow-up non-contrast CT scans within 6\u202fh and 72\u202fh after symptom onset, respectively. Univariate and multivariate logistic regression analyses were used to identify independent predictors of HE. A decision tree model was developed for HE prediction.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 417 patients were included, with 64 (15.3%) exhibiting HE on follow-up imaging. Multivariate analysis revealed that midline shift (odds ratio [OR], 1.18; 95% confidence interval [CI], 1.07\u20131.30;\n                      <jats:italic>p<\/jats:italic>\n                      \u202f=\u202f0.001), time to initial CT scan (OR, 0.71; 95% CI, 0.57\u20130.88;\n                      <jats:italic>p<\/jats:italic>\n                      \u202f=\u202f0.002), and presence of blend sign (OR, 2.81; 95% CI, 1.33\u20135.97;\n                      <jats:italic>p<\/jats:italic>\n                      \u202f=\u202f0.007) were independently associated with HE. Our decision tree model achieved an AUC of 0.803 (95% CI, 0.736\u20130.856), a sensitivity of 81.1% and specificity of 67.1% in the training set, and 0.748 (95% CI, 0.581\u20130.880), 81.8 and 65.8% in the test set, respectively. It outperformed the HEP model. Although the BRAIN model had a higher AUC, our model achieved a higher sensitivity (81.8% vs. 72.7%), a key advantage for identifying patients needing timely intervention.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>We developed a simple, interpretable decision tree model to predict HE in women. This tool may support clinicians in identifying high-risk patients and guiding timely interventions.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fneur.2026.1824336","type":"journal-article","created":{"date-parts":[[2026,9,7]],"date-time":"2026-09-07T05:27:31Z","timestamp":1788758851000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["A decision tree model for hematoma expansion prediction in women after spontaneous intracerebral hemorrhage"],"prefix":"10.3389","volume":"17","author":[{"given":"Ruowen","family":"Hu","sequence":"first","affiliation":[{"name":"Medical Quality Control Department, The First Affiliated Hospital of Wenzhou Medical University","place":["Wenzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaoyu","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Radiology, The First Affiliated Hospital of Wenzhou Medical University","place":["Wenzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xingchen","family":"Zhou","sequence":"additional","affiliation":[{"name":"Department of Radiology, The First Affiliated Hospital of Wenzhou Medical University","place":["Wenzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jinjin","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Radiology, The First Affiliated Hospital of Wenzhou Medical University","place":["Wenzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yiqin","family":"Zhang","sequence":"additional","affiliation":[{"name":"Information Department, The First Affiliated Hospital of Wenzhou Medical University","place":["Wenzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,9,7]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"838","DOI":"10.1161\/STROKEAHA.124.050131","article-title":"Ultra-early hematoma expansion is associated with ongoing hematoma growth and poor functional outcome","volume":"56","author":"Mutimer","year":"2025","journal-title":"Stroke"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"e1606","DOI":"10.1212\/WNL.0000000000207728","article-title":"Association between hematoma expansion severity and outcome and its interaction with baseline intracerebral hemorrhage volume","volume":"101","author":"Morotti","year":"2023","journal-title":"Neurology"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"559","DOI":"10.1007\/s12028-011-9538-3","article-title":"Antihypertensive treatment of acute cerebral hemorrhage (ATACH) II: design, methods, and 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