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Basic Surveillance Parameters Improve the Prediction of Delayed Cerebral Infarction After Aneurysmal Subarachnoid Hemorrhage.

Basic Surveillance Parameters Improve the Prediction of Delayed Cerebral Infarction After Aneurysmal Subarachnoid Hemorrhage.

Authors :
Csók, István
Grauvogel, Jürgen
Scheiwe, Christian
Bardutzky, Jürgen
Wehrum, Thomas
Beck, Jürgen
Reinacher, Peter C.
Roelz, Roland
Source :
Frontiers in Neurology; 3/2/2022, Vol. 13, p1-9, 9p
Publication Year :
2022

Abstract

Background: To establish a practical risk chart for prediction of delayed cerebral infarction (DCI) after aneurysmal subarachnoid hemorrhage (aSAH) by using information that is available until day 5 after ictus. Methods: We assessed all consecutive patients with aSAH admitted to our service between September 2008 and September 2015 (n = 417). The data set was randomly split into thirds. Two-thirds were used for model development and one-third was used for validation. Characteristics that were present between the bleeding event and day 5 (i.e., prior to >95% of DCI diagnoses) were assessed to predict DCI by using logistic regression models. A simple risk chart was established and validated. Results: The amount of cisternal and ventricular blood on admission CT (Hijdra sum score), early sonographic vasospasm (i.e., mean flow velocity of either intracranial artery >160 cm/s until day 5), and a simplified binary level of consciousness score until day 5 were the strongest predictors of DCI. A model combining these predictors delivered a high predictive accuracy [the area under the receiver operating characteristic (AUC) curve of 0.82, Nagelkerke's R <superscript>2</superscript> 0.34 in the development cohort]. Validation of the model demonstrated a high discriminative capacity with the AUC of 0.82, Nagelkerke's R <superscript>2</superscript> 0.30 in the validation cohort. Conclusion: Adding level of consciousness and sonographic vasospasm between admission and postbleed day 5 to the initial blood amount allows for simple and precise prediction of DCI. The suggested risk chart may prove useful for selection of appropriate candidates for interventions to prevent DCI. [ABSTRACT FROM AUTHOR]

Details

Language :
English
ISSN :
16642295
Volume :
13
Database :
Complementary Index
Journal :
Frontiers in Neurology
Publication Type :
Academic Journal
Accession number :
155524039
Full Text :
https://doi.org/10.3389/fneur.2022.774720