Analysis of Risk Factors and Construction of Nomogram Prediction Model for Hydrocephalus after Intracranial Hemorrhage in Children

Analysis of Risk Factors and Construction of Nomogram Prediction Model for Hydrocephalus after Intracranial Hemorrhage in Children | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Article Analysis of Risk Factors and Construction of Nomogram Prediction Model for Hydrocephalus after Intracranial Hemorrhage in Children Jianxun He This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-8884477/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Background: Intracranial hemorrhage (ICH) in children can cause serious complications like post‐hemorrhagic hydrocephalus (PHH). Early identification of PHH risk factors is crucial for timely intervention, so we aimed to identify independent predictors of PHH and develop a simplified nomogram for timely risk estimation. Methods: In this single‑center retrospective cohort study, 147 children (≤12 years) with radiologically confirmed ICH (September 2016-August 2024) were analyzed. Patients were classified as PHH (n=36) or non‐PHH (n=111) based on clinical and imaging criteria. Candidate predictors were pre‑specified from clinical relevance and prior literature: age group, admission Glasgow Coma Scale (GCS), CSF total protein, intraventricular hemorrhage (IVH), and concomitant subarachnoid hemorrhage (SAH). Multivariable logistic regression identified independent predictors, and a nomogram was constructed. Internal bootstrap validation assessed optimism-corrected calibration and discrimination. Results: PHH developed in 24.5% of patients. Five predictors were retained in the final model: younger age (OR = 2.81, 95% CI: 1.03-7.72), lower GCS score (OR = 2.76, 95% CI: 1.21-6.30), elevated CSF protein (OR = 5.54, 95% CI: 1.70-18.10), intraventricular hemorrhage (OR = 8.85, 95% CI: 2.36-33.18), and subarachnoid hemorrhage (OR = 5.10, 95% CI: 1.28-20.38). The nomogram demonstrated apparent discrimination (AUC = 0.94) and reasonable calibration within this dataset. Performance estimates should be interpreted cautiously given the limited events-per-variable (EPV) ratio and reliance on internal validation. Conclusion: A simplified five-variable nomogram offers an exploratory tool to estimate PHH risk in pediatric ICH. External, prospective multi-center validation is required before clinical implementation. Health sciences/Diseases Health sciences/Medical research Health sciences/Neurology Biological sciences/Neuroscience Health sciences/Risk factors Intracranial hemorrhage hydrocephalus children risk factors prediction model nomogram Full Text Additional Declarations No competing interests reported. Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-8884477","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Article","associatedPublications":[],"authors":[{"id":592787320,"identity":"d6a3dae9-761f-4097-b7fd-4785251b653b","order_by":0,"name":"Jianxun He","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA3klEQVRIie3RPcoCMRCA4YGFVINrOQHRKwSFYCF4lQ0LVn5gJVtYKIoWKl7FSiyVSKrYb/etN9DOzt9SMWtnkafOSzIZAM/7QSwcbg/HcwND0NssSnrupEAmrvFZq8QHJhaZNe6kDG1JyHRDaCv5YRTkeBiYFhEGKIyVieozCCfT6HMSDHW9U2fIremmal0Csvul6xaVEiIWUr1KlWUg6M+VtMVtFkL4z2RHjYNcSfWWCCxudhLyJc9PjpD3TUyRNeicpbJ4rPLSvK/ydE565XAy/5y8wO+Oe57neW9dAUuQS8UNRKqRAAAAAElFTkSuQmCC","orcid":"","institution":"Gansu Provincial Maternity and Child-care Hospital","correspondingAuthor":true,"prefix":"","firstName":"Jianxun","middleName":"","lastName":"He","suffix":""}],"badges":[],"createdAt":"2026-02-15 07:53:14","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-8884477/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-8884477/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":103056403,"identity":"2bab3b66-fa86-4cc3-95bc-f3c563c1c328","added_by":"auto","created_at":"2026-02-20 09:09:18","extension":"pdf","order_by":1,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":520707,"visible":true,"origin":"","legend":"","description":"","filename":"paper2.pdf","url":"https://assets-eu.researchsquare.com/files/rs-8884477/v1_covered_bd9fe126-afe4-48c9-b981-6ece502f53c3.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Analysis of Risk Factors and Construction of Nomogram Prediction Model for Hydrocephalus after Intracranial Hemorrhage in Children","fulltext":[],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":false,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":true,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":true,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":true,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"Intracranial hemorrhage, hydrocephalus, children, risk factors, prediction model, nomogram","lastPublishedDoi":"10.21203/rs.3.rs-8884477/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-8884477/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cstrong\u003eBackground: \u003c/strong\u003eIntracranial hemorrhage (ICH) in children can cause serious complications like post‐hemorrhagic hydrocephalus (PHH). Early identification of PHH risk factors is crucial for timely intervention, so we aimed to identify independent predictors of PHH and develop a simplified nomogram for timely risk estimation.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMethods: \u003c/strong\u003eIn this single‑center retrospective cohort study, 147 children (≤12 years) with radiologically confirmed ICH (September 2016-August 2024) were analyzed. Patients were classified as PHH (n=36) or non‐PHH (n=111) based on clinical and imaging criteria. Candidate predictors were pre‑specified from clinical relevance and prior literature: age group, admission Glasgow Coma Scale (GCS), CSF total protein, intraventricular hemorrhage (IVH), and concomitant subarachnoid hemorrhage (SAH). Multivariable logistic regression identified independent predictors, and a nomogram was constructed. Internal bootstrap validation assessed optimism-corrected calibration and discrimination.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eResults:\u003c/strong\u003e PHH developed in 24.5% of patients. Five predictors were retained in the final model: younger age (OR = 2.81, 95% CI: 1.03-7.72), lower GCS score (OR = 2.76, 95% CI: 1.21-6.30), elevated CSF protein (OR = 5.54, 95% CI: 1.70-18.10), intraventricular hemorrhage (OR = 8.85, 95% CI: 2.36-33.18), and subarachnoid hemorrhage (OR = 5.10, 95% CI: 1.28-20.38). The nomogram demonstrated apparent discrimination (AUC = 0.94) and reasonable calibration within this dataset. Performance estimates should be interpreted cautiously given the limited events-per-variable (EPV) ratio and reliance on internal validation.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConclusion:\u003c/strong\u003e A simplified five-variable nomogram offers an exploratory tool to estimate PHH risk in pediatric ICH. External, prospective multi-center validation is required before clinical implementation.\u003c/p\u003e","manuscriptTitle":"Analysis of Risk Factors and Construction of Nomogram Prediction Model for Hydrocephalus after Intracranial Hemorrhage in Children","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2026-02-18 05:14:56","doi":"10.21203/rs.3.rs-8884477/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"782d6c8d-cc25-403d-a021-8af13a4e3946","owner":[],"postedDate":"February 18th, 2026","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[{"id":63075527,"name":"Health sciences/Diseases"},{"id":63075528,"name":"Health sciences/Medical research"},{"id":63075529,"name":"Health sciences/Neurology"},{"id":63075530,"name":"Biological sciences/Neuroscience"},{"id":63075531,"name":"Health sciences/Risk factors"}],"tags":[],"updatedAt":"2026-02-18T05:14:58+00:00","versionOfRecord":[],"versionCreatedAt":"2026-02-18 05:14:56","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-8884477","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-8884477","identity":"rs-8884477","version":["v1"]},"buildId":"XKTyCvWXoU3ODBz1xrDgd","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}