Validation and Comparison of Aneurysmal Subarachnoid Hemorrhage Grading Scales in Angiogram-Negative Subarachnoid Hemorrhage Patients
Validation and Comparison of Aneurysmal Subarachnoid Hemorrhage Grading Scales in Angiogram-Negative Subarachnoid Hemorrhage Patients
复制标题
血管造影阴性蛛网膜下腔出血患者动脉瘤性蛛网膜下腔出血分级量表的验证和比较
DOI：
10.1155/2020/9707238
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发表时间：
2020-03-02
影响因子：
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通讯作者：
Zhang, Jianmin
中科院分区：
文献类型：
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作者：
Fang, Yuanjian;Xu, Shenbin;Zhang, Jianmin
已经提出了许多分级量表来预测蛛网膜下腔出血（SAH）的结局;然而，这些分级量表尚未在血管造影阴性的SAH患者中得到验证。在这项研究中，我们的目的是验证和比较血管造影阴性SAH患者的蛛网膜下腔出血分级量表。2014年1月至2015年12月，分析了190例血管造影阴性SAH患者。结果以迟发性脑缺血（DCI）和不良结局（定义为改良兰金量表（mRS）3-6或4-6）来衡量。通过评估分布、趋势、关联和区分度，评估分级量表的预测性能。关于分布，没有患者被归类为HAIR 8和SAH评分8。两种分级量表均显示评分与结局之间有显著性趋势（P < 0.05），且与结局相关（OR > 1）。改良Fisher量表（mFS）、世界神经外科学会联合会量表（WFNS）以及VASOGRADE和HAIR联合评分显示了DCI的良好预测准确性（曲线下面积（AUC）> 0.750）。除mFS和蛛网膜下腔出血早期脑水肿评分（SEBES）外，每个量表的预测准确性在预测不良结局方面表现良好。然而，当预测mRS 4-6时，mFS的准确性增加。VASOGRADE、HAIR和WFNS可能是预测DCI和不良结局的有价值的预后工具。mFS可适用于预测DCI和mRS 4-6。SAH评分和Hunt-Hess评分也是预测不良结局的最佳指标。与其他量表相比，SEBES的预测性能相对较差。
Numerous grading scales have been proposed to predict the outcome of aneurysmal subarachnoid hemorrhage (SAH); however, these have not been validated in angiogram-negative SAH patients. In this study, we aim to validate and compare the aneurysmal SAH grading scales in angiogram-negative SAH patients. There were 190 angiogram-negative SAH patients analyzed from January 2014 to December 2015. The outcomes were measured by delayed cerebral ischemia (DCI) and poor outcome (defined as modified Rankin Scale (mRS) 3-6 or 4-6). The predictive performance of the grading scales was assessed via evaluation of distribution, trend, association, and discrimination. In regard to the distribution, none of the patients were categorized as HAIR 8 and SAH score 8. Both grading scales indicated a significant trend between scores and outcome (P < 0.05), and association with the outcome (OR > 1). The modified Fisher Scale (mFS), World Federation of Neurosurgical Societies scale (WFNS), and combined scores VASOGRADE and HAIR showed good predictive accuracy (area under the curve (AUC) > 0.750) for DCI. The predictive accuracy in each scale performed well in predicting poor outcome, with the exception of mFS and the Subarachnoid hemorrhage Early Brain Edema Score (SEBES). However, the mFS performed with increased accuracy when predicting mRS 4-6. The VASOGRADE, HAIR, and WFNS may be valuable prognostic tools for predicting both DCI and poor outcome. The mFS can be applicable for predicting DCI and mRS 4-6. The SAH score and the Hunt-Hess were also optimal for predicting poor outcome. The predictive performance of SEBES was relatively poor compared to the other scales.