A preliminary study of the clinical predictive model for risk factors of delayed cerebral ischemia following aneurysmal subarachnoid hemorrhage
HAN Yuwei
HAO Guangzhi
CHEN Ligang
HUO Da
LI Xiaoming
LIANG Guobiao
ZHU Tingzhun
Abstract：Objective To establish a clinical prediction model for delayed cerebral ischemia(DCI)after aneurysmal subarachnoid hemorrhage(aSAH)and to investigate its risk factors.Methods Clinical data of 651 patients with aSAH were analyzed retrospectively.Based on the occurrence of DCI,these patients were categorized into non-DCI group(494 cases)and DCI group(157 cases).Potential risk factors were screened through univariate analysis.A predictive model was then constructed using multivariate logistic regression analysis.The predictive performance and accuracy of the model were evaluated using the receiver operating characteristic(ROC)curve and the calibration curve.Results Univariate analysis revealed that surgical method,hydrocephalus,World Federation of Neurological Surgeons(WFNS)grade,Glasgow Coma Scale(GCS)score,Hunt-Hess grade,modified Fisher(mFisher)score,prothrombin time(PT),international normalized ratio(INR),activated partial thromboplastin time(APTT),D-dimer,and fibrin degradation products(FDP)were significantly associated with the occurrence of DCI(all P<0.05).Variables that were statistically significant in the univariate analysis were included in the multivariate logistic regression analysis,which showed that craniotomy,GCS score of 3-7,mFisher score≥3,PT>13 s,INR>1.2,and D-dimer>0.55 mg/L were independent risk factors for DCI.Based on the results of the multivariate logistic regression analysis,variables with statistical significance were incorporated into the prediction model.The equation for constructing the prediction model was:Log[P(Y=1)/1-P(Y=1)]=β0+β1X1+β2X2+...+βkXk.The 651 patients were randomly divided into a model training set(456 patients)and a model validation set(195 patients)at a 7:3 ratio.The area under the ROC curve in the validation set was 0.861,and the calibration curve indicated good predictive performance of the model.Conclusion Craniotomy,GCS score,mFisher score,PT,INR,and D-dimer are independent risk factors for DCI following aSAH.The constructed prediction model has high predictive efficacy and can provide a reference for early clinical intervention.
Keywords：subarachnoid hemorrhagebrain ischemiarisk factorspredictive model
Publication Date：2026-02-20
Online Publishing Date：2026-03-18(First online date of this platform, not the publication date of the document)
Pages：6( 82-87 )