Publication:
A model for predicting outcome following surgical clipping in patients with aneurysmal subarachnoid hemorrhage

0
0

Issued Date

2017

Resource Type

Article

File Type

application/pdf

ISSN

1252208

Other identifier(s)

2-s2.0-85075012678

Rights Holder(s)

Scopus

Bibliographic Citation

Journal of the Medical Association of Thailand. Vol 100, No.10 (2017), p.S87-S94

Suggested Citation

Srikaew S., Kaewpradit A., Kongkasem K., Songtish D. A model for predicting outcome following surgical clipping in patients with aneurysmal subarachnoid hemorrhage. Journal of the Medical Association of Thailand. Vol 100, No.10 (2017), p.S87-S94. Retrieved from: https://hdl.handle.net/20.500.14740/4503

Title

A model for predicting outcome following surgical clipping in patients with aneurysmal subarachnoid hemorrhage

Author(s)

Srikaew S.
 Kaewpradit A.
 Kongkasem K.
 Songtish D.

Abstract

Background: Aneurysmal subarachnoid hemorrhage is one of the most serious neurosurgical conditions. There are a few studies in Thai population. Objective: To investigate factors related to poor outcome after cerebral aneurysms clipping and establish a risk score model to predict unfavorable outcome. Material and Method: A nested case-control study was conducted from cohort data between January 2010 to December 2016 at Her Royal Highness Princess Maha Chakri Sirindhorn Medical Center and Saraburi Hospital. One hundred and sixty-eight aneurysmal subarachnoid hemorrhage patients were enrolled in the study. Surgical outcome was assessed by Glasgow Outcome Scale (GOS). The number of the case per control was 1: 1. Factors associated with unfavorable outcome were analyzed. A risk score model was developed by backward stepwise binary logistic regression analysis, and the Receiver Operating Characteristic (ROC) curve was constructed. Results: Factors associated with poor outcome were the Modified Fisher grading scale of grade 3 or 4 (OR 17.8; 95% CI 6.8 to 46.7), the best motor response of Glasgow Coma Scale M4 or M5 (OR 8.1; 95% CI 3.2 to 20.4), and age of patients over than 60 years (OR 3.2; 95% CI 1.2 to 8.4). The final risk score model = 1 (age over than 60) +2.5 (GCS M4 or M5) +5.5 (Modified Fisher grading scale 3 or 4). The corresponding ROC for the accuracy of predicting the unfavorable outcome was 0.91; 95% CI 0.86 to 0.95 (p<0.001). Conclusion: The simple risk score model based on three independent factors (Modified Fisher grading scale of grade 3 or 4, the best motor response of GCS being M4 or M5, and the age of the patients >60 years) was created to predict unfavorable outcome. © 2017 Medical Association of Thailand. All rights reserved.

Subject(s)

Adult
 Aneurysm clipping
 Anterior cerebral artery
 Anterior communicating artery aneurysm
 Article
 Brain artery aneurysm
 Case control study
 Controlled study
 Diagnostic accuracy
 Female
 Glasgow coma scale
 Human
 Internal carotid artery aneurysm
 Male
 Middle aged
 Modified Fisher grading scale
 Mortality
 Posterior communicating artery
 Posterior inferior cerebellar artery
 Predictive value
 Receiver operating characteristic
 Risk assessment
 Sample size
 Sensitivity and specificity
 Subarachnoid hemorrhage
 Treatment outcome
 World Federation of Neurosurgeons Scale

View online Resources

Research Projects

Organizational Units

Journal Issue

URI

https://hdl.handle.net/20.500.14740/4503

Collections

Scopus: Year 1983-2021

Endorsement

Review

Supplemented By

Referenced By