Scoring Model to Predict Functional Outcome in Poor-Grade Aneurysmal Subarachnoid Hemorrhage
| Autor: | Xinfa Pan, Zhikai Xie, Renya Zhan, Jie Shen, Guofeng Yu, Lihui Zhou, Jianwei Pan, Zongchi Liu, Kaiyuan Huang, Rajneesh Mungur, Sicong Huang, Jianbo Yu, Dexin Cheng |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
medicine.medical_specialty
Subarachnoid hemorrhage Logistic regression lcsh:RC346-429 03 medical and health sciences 0302 clinical medicine Modified Rankin Scale Internal medicine Medicine Poor grade 030212 general & internal medicine lcsh:Neurology. Diseases of the nervous system Original Research model business.industry Area under the curve scoring system poor-grade Odds ratio medicine.disease Hydrocephalus Neurology Cohort Neurology (clinical) prognosis aneurysmal subarachnoid hemorrhage business 030217 neurology & neurosurgery |
| Zdroj: | Frontiers in Neurology Frontiers in Neurology, Vol 12 (2021) |
| ISSN: | 1664-2295 |
| Popis: | Background: Patients with poor-grade aneurysmal subarachnoid hemorrhage (aSAH), defined as World Federation of Neurosurgical Societies (WFNS) grades IV–V have high rates of disability and mortality. The objective of this study was to accurately prognosticate the outcomes of patients with poor-grade aSAH by developing a new scoring model.Methods: A total of 147 poor-grade aSAH patients in our center were enrolled. Risk variables identified by multivariate logistic regression analysis were used to devise a scoring model (total score, 0–9 points). The scores were estimated on the basis of β coefficients. A cohort of 68 patients from another institute was used to validate the model.Results: Multivariate logistic regression analysis revealed that modified Fisher grade >2 [odds ratio [OR], 2.972; P = 0.034], age ≥65 years (OR, 3.534; P = 0.006), conservative treatment (OR, 5.078; P = 0.019), WFNS grade V (OR, 2.638; P = 0.029), delayed cerebral ischemia (OR, 3.170; P = 0.016), shunt-dependent hydrocephalus (OR, 3.202; P = 0.032), and cerebral herniation (OR, 7.337; P < 0.001) were significant predictors for poor prognosis [modified Rankin Scale [mRS] ≥3]. A scoring system was constructed by the integration of these factors and divided the poor-grade aSAH patients into three categories: low risk (0–1 points), intermediate risk (2–3 points), and high risk (4–9 points), with predicted risks of poor prognosis of 11, 52, and 87%, respectively (P < 0.001). The area under the curve in the derivation cohort was 0.844 (95% CI, 0.778–0.909). The AUC in the validation cohort was 0.831 (95% CI, 0.732–0.929).Conclusions: The new scoring model can improve prognostication and help decision-making for subsequent complementary treatment in patients with aSAH. |
| Databáze: | OpenAIRE |
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