Construction and validation of a prognostic model for one-year outcomes of patients with aneurysmal subarachnoid hemorrhage after surgery
SHAO Shi-ke
ZHU Xian-long
DONG Wen-sheng
YIN Peng
CHEN De-shun
FAN Yong-jun
ZHONG Chong-pei
Abstract：Objective To investigate the risk factors affecting the 1-year prognosis of patients with aneurysmal subarachnoid hemorrhage (aSAH) following surgery and to develop a nomogram model for validation. Methods The clinical data of 180 patients with aSAH who underwent surgery from March 2018 to December 2023 were retrospectively analyzed. One year post-surgery,the prognosis was assessed using the modified Rankin Scale score,where scores of 0～2 indicated a good prognosis and≥3 indicated a poor prognosis. Lasso and logistic regression models were utilized to identify the factors influencing prognosis,and the nomogram and receiver operating characteristic (ROC) curve were employed for validation. Results One year post-surgery,62 patients had a poor prognosis,and 118 had a good prognosis. Univariate analysis revealed that age,preoperative modified Fisher grade,rebleeding,hydrocephalus,Glasgow Coma Scale (GCS) score on admission,preoperative Hunt-Hess grade,and aneurysm shape were significantly associated with aSAH patient prognosis (P<0.05). Lasso regression and multivariate logistic regression analysis demonstrated that age ≥60 years (OR=2.228;95％CI 1.045～4.746;P=0.038),GCS score≤8 on admission (OR=4.104;95％CI 1.376～12.225;P=0.012),and preoperative Hunt-Hess grade≥3 (OR=4.382;95％CI 2.001～9.572;P<0.001) were independent risk factors for a poor prognosis of patients with aSAH one year after surgery. A nomogram model was constructed based on these three risk factors. ROC curve analysis indicated that the area under the curve for predicting a poor prognosis using the nomogram model was 0.794 (95％ CI 0.723～0.866),with a sensitivity of 77.1％ and a specificity of 74.2％. Conclusion A GCS score ≤8 on admission,a preoperative Hunt-Hess grade ≥3,and age ≥60 years are independent risk factors for a poor prognosis of patients with aSAH one year after surgery. The prediction model based on these indicators demonstrates high predictive efficacy for patient prognosis.
Keywords：Aneurysmal subarachnoid hemorrhagePrognosisRisk factorsPrediction model
Publication Date：2024-09-25
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：6( 532-536,540 )