Risk factors for poor prognosis after endovascular intervention in low-grade(WFNS grades Ⅰ and Ⅱ)aneurysmal subarachnoid hemorrhage
WEI Jie
GUO Cui-xia
ZHANG Ning
LI Xin-hao
ZHU Xu
Abstract：Objective To investigate risk factors for poor prognosis after endovascular intervention in low-grade(WFNS gradesⅠandⅡ)aneurysmal subarachnoid hemorrhage(aSAH)and evaluate the predictive efficacy of a nomogram model.Methods The clinical data of 238 patients with low-grade aSAH undergoing endovascular treatment from January 2017 to January 2022 were retrospectively analyzed.The modified Rankin Scale(mRS)at 12 months postoperatively assessed clinical outcomes,with a mRS score of 0～2 as good prognosis,and mRS 3～6 as poor.Multivariate logistic regression identified independent risk factors for poor prognosis,and a nomogram prediction model was constructed.Receiver operating characteristic(ROC)curves,calibration curves,and decision curve analysis(DCA)evaluated model performance.Results Among 238 patients,43(18.07%)had poor outcomes.Multivariate analysis identified six independent risk factors including age≥65 years,WFNS grade Ⅱ,delayed cerebral ischemia(DCI),intracranial hematoma,low hemoglobin,and shunt-dependent hydrocephalus(P<0.05).The nomogram model demonstrated based on the above six risk factors,and ROC curve showed an AUC of 0.8666(95%CI 0.8106～0.9226),a sensitivity of 90.70%,and a specificity of 68.21%.Calibration curve closely aligned with ideal curve.DCA showed positive net benefit at threshold probabilities of 0.00～0.10.Conclusion Age≥65 years,WFNS gradeⅡ,DCI,intracranial hematoma,low hemoglobin,and shunt-dependent hydrocephalus are independent risk factors for poor prognosis in low-grade aSAH patients.The nomogram model based on these factors exhibits strong predictive value.
Keywords：Aneurysmal subarachnoid hemorrhageWFNS grade Ⅰ and ⅡPrognosisRisk factorNomogram model
Publication Date：2025-05-25
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：6( 292-297 )