摘要BACKGROUND:Intracranial hemorrhage(ICH),a severe complication among adults receiving extracorporeal membrane oxygenation(ECMO),is often related to poor outcomes.This study aimed to establish a predictive model for ICH in adults receiving ECMO treatment.METHODS:Adults who received ECMO between January 2017 and June 2022 were the subjects of a single-center retrospective study.Patients under the age of 18 years old,with acute ICH before ECMO,with less than 24 h of ECMO support,and with incomplete data were excluded.ICH was diagnosed by a head computed tomography scan.The outcomes included the incidence of ICH,in-hosptial mortality and 28-day mortality.Multivariate logistic regression analysis was used to identify relevant risk factors of ICH,and a predictive model of ICH with a nomogram was constructed.RESULTS:Among the 227 patients included,22 developed ICH during ECMO.Patients with ICH had higher in-hospital mortality(90.9%vs.47.8%,P=0.001)and higher 28-day mortality(81.8%vs.47.3%,P=0.001)than patients with non-ICH.ICH was associated with decreased grey-white-matter ratio(GWR)(OR=0.894,95%CI:0.841-0.951,P<0.001),stroke history(OR=4.265,95%CI:1.052-17.291,P=0.042),fresh frozen plasma(FFP)transfusion(OR=1.208,95%CI:1.037-1.408,P=0.015)and minimum platelet(PLT)count during ECMO support(OR=0.977,95%CI:0.958-0.996,P=0.019).The area under the receiver operating characteristic curve of the ICH predictive model was 0.843(95%CI:0.762-0.924,P<0.001).CONCLUSION:ECMO-treated patients with ICH had a higher risk of death.GWR,stroke history,FFP transfusion,and the minimum PLT count were independently associated with ICH,and the ICH predictive model showed that these parameters performed well as diagnostic tools.