Development and validation of a predictive model for the prognosis in aneurysmal subarachnoid hemorrhage

J Clin Lab Anal. 2020 Dec;34(12):e23542. doi: 10.1002/jcla.23542. Epub 2020 Aug 29.

Abstract

Background: This study was to conduct a predictive model for the prognosis of aneurysmal subarachnoid hemorrhage (aSAH) and validate the clinical data.

Methods: A total of 235 aSAH patients were enrolled in this study, dividing into the favorable or poor prognosis groups based on Modified Rankin Scale (mRS) at 3 months postoperatively. Multivariate analysis was assessed using binary Logistic regression and Fisher discriminant analysis. The receiver operating characteristic (ROC) curve was used to determine the cut-off value.

Results: Our findings showed that the high Glasgow Coma Scale (GCS) score 24-hour after surgery reduced the risk of poor prognosis, and the surgical clipping and elevated neutrophil-lymphocyte ratio (NLR) increased the risk of poor prognosis. The discriminant function was V = 0.881 × GCS score - 0.523 × NLR - 0.422 × therapeutic approach, and V = -0.689 served as a cut-off value. When V ≥ -0.689, the good prognosis was considered among these patients with aSAH. The correctness for predicting the prognostic outcomes by self-validation was 85.11%.

Conclusion: This predictive model established by a discriminant analysis is a useful tool for predicting the prognostic outcomes of aSAH patients, which may help clinicians identify patients at high risk for poor prognosis and optimize treatment after surgery.

Keywords: aneurysmal subarachnoid hemorrhage; discriminant analysis; prognosis; validation.

MeSH terms

  • Aged
  • Discriminant Analysis
  • Female
  • Glasgow Coma Scale
  • Humans
  • Leukocyte Count
  • Male
  • Middle Aged
  • Models, Statistical
  • Prognosis
  • ROC Curve
  • Reproducibility of Results
  • Retrospective Studies
  • Subarachnoid Hemorrhage* / diagnosis
  • Subarachnoid Hemorrhage* / epidemiology
  • Subarachnoid Hemorrhage* / mortality
  • Subarachnoid Hemorrhage* / therapy