Prediction of two month modified Rankin Scale with an ordinal prediction model in patients with aneurysmal subarachnoid haemorrhage
<p style="text-align:justify;"> <b>Background:</b> Aneurysmal subarachnoid haemorrhage (aSAH) is a devastating event with a frequently disabling outcome. Our aim was to develop a prognostic model to predict an ordinal clinical outcome at two months in patients with aSAH....
| Main Authors: | , , , , , , , |
|---|---|
| Format: | Journal article |
| Language: | English |
| Published: |
BioMed Central
2010
|
| _version_ | 1826281441163476992 |
|---|---|
| author | Risselada, R Lingsma, H Molyneux, A Kerr, R Yarnold, J Sneade, M Steyerberg, E Sturkenboom, M |
| author_facet | Risselada, R Lingsma, H Molyneux, A Kerr, R Yarnold, J Sneade, M Steyerberg, E Sturkenboom, M |
| author_sort | Risselada, R |
| collection | OXFORD |
| description | <p style="text-align:justify;"> <b>Background:</b> Aneurysmal subarachnoid haemorrhage (aSAH) is a devastating event with a frequently disabling outcome. Our aim was to develop a prognostic model to predict an ordinal clinical outcome at two months in patients with aSAH. <br/><br/> <b>Methods:</b> We studied patients enrolled in the International Subarachnoid Aneurysm Trial (ISAT), a randomized multicentre trial to compare coiling and clipping in aSAH patients.<br/><br/> Several models were explored to estimate a patient's outcome according to the modified Rankin Scale (mRS) at two months after aSAH. Our final model was validated internally with bootstrapping techniques.<br/><br/> <b>Results:</b> The study population comprised of 2,128 patients of whom 159 patients died within 2 months (8%). Multivariable proportional odds analysis identified World Federation of Neurosurgical Societies (WFNS) grade as the most important predictor, followed by age, sex, lumen size of the aneurysm, Fisher grade, vasospasm on angiography, and treatment modality. The model discriminated moderately between those with poor and good mRS scores (c statistic = 0.65), with minor optimism according to bootstrap re-sampling (optimism corrected c statistic = 0.64).<br/><br/> <b>Conclusion:</b> We presented a calibrated and internally validated ordinal prognostic model to predict two month mRS in aSAH patients who survived the early stage up till a treatment decision. Although generalizability of the model is limited due to the selected population in which it was developed, this model could eventually be used to support clinical decision making after external validation. </p> |
| first_indexed | 2024-03-07T00:28:51Z |
| format | Journal article |
| id | oxford-uuid:7f124dcf-b6c4-4c40-81cd-97d4aa1279b9 |
| institution | University of Oxford |
| language | English |
| last_indexed | 2024-03-07T00:28:51Z |
| publishDate | 2010 |
| publisher | BioMed Central |
| record_format | dspace |
| spelling | oxford-uuid:7f124dcf-b6c4-4c40-81cd-97d4aa1279b92022-03-26T21:14:26ZPrediction of two month modified Rankin Scale with an ordinal prediction model in patients with aneurysmal subarachnoid haemorrhageJournal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:7f124dcf-b6c4-4c40-81cd-97d4aa1279b9EnglishSymplectic Elements at OxfordBioMed Central2010Risselada, RLingsma, HMolyneux, AKerr, RYarnold, JSneade, MSteyerberg, ESturkenboom, M <p style="text-align:justify;"> <b>Background:</b> Aneurysmal subarachnoid haemorrhage (aSAH) is a devastating event with a frequently disabling outcome. Our aim was to develop a prognostic model to predict an ordinal clinical outcome at two months in patients with aSAH. <br/><br/> <b>Methods:</b> We studied patients enrolled in the International Subarachnoid Aneurysm Trial (ISAT), a randomized multicentre trial to compare coiling and clipping in aSAH patients.<br/><br/> Several models were explored to estimate a patient's outcome according to the modified Rankin Scale (mRS) at two months after aSAH. Our final model was validated internally with bootstrapping techniques.<br/><br/> <b>Results:</b> The study population comprised of 2,128 patients of whom 159 patients died within 2 months (8%). Multivariable proportional odds analysis identified World Federation of Neurosurgical Societies (WFNS) grade as the most important predictor, followed by age, sex, lumen size of the aneurysm, Fisher grade, vasospasm on angiography, and treatment modality. The model discriminated moderately between those with poor and good mRS scores (c statistic = 0.65), with minor optimism according to bootstrap re-sampling (optimism corrected c statistic = 0.64).<br/><br/> <b>Conclusion:</b> We presented a calibrated and internally validated ordinal prognostic model to predict two month mRS in aSAH patients who survived the early stage up till a treatment decision. Although generalizability of the model is limited due to the selected population in which it was developed, this model could eventually be used to support clinical decision making after external validation. </p> |
| spellingShingle | Risselada, R Lingsma, H Molyneux, A Kerr, R Yarnold, J Sneade, M Steyerberg, E Sturkenboom, M Prediction of two month modified Rankin Scale with an ordinal prediction model in patients with aneurysmal subarachnoid haemorrhage |
| title | Prediction of two month modified Rankin Scale with an ordinal prediction model in patients with aneurysmal subarachnoid haemorrhage |
| title_full | Prediction of two month modified Rankin Scale with an ordinal prediction model in patients with aneurysmal subarachnoid haemorrhage |
| title_fullStr | Prediction of two month modified Rankin Scale with an ordinal prediction model in patients with aneurysmal subarachnoid haemorrhage |
| title_full_unstemmed | Prediction of two month modified Rankin Scale with an ordinal prediction model in patients with aneurysmal subarachnoid haemorrhage |
| title_short | Prediction of two month modified Rankin Scale with an ordinal prediction model in patients with aneurysmal subarachnoid haemorrhage |
| title_sort | prediction of two month modified rankin scale with an ordinal prediction model in patients with aneurysmal subarachnoid haemorrhage |
| work_keys_str_mv | AT risseladar predictionoftwomonthmodifiedrankinscalewithanordinalpredictionmodelinpatientswithaneurysmalsubarachnoidhaemorrhage AT lingsmah predictionoftwomonthmodifiedrankinscalewithanordinalpredictionmodelinpatientswithaneurysmalsubarachnoidhaemorrhage AT molyneuxa predictionoftwomonthmodifiedrankinscalewithanordinalpredictionmodelinpatientswithaneurysmalsubarachnoidhaemorrhage AT kerrr predictionoftwomonthmodifiedrankinscalewithanordinalpredictionmodelinpatientswithaneurysmalsubarachnoidhaemorrhage AT yarnoldj predictionoftwomonthmodifiedrankinscalewithanordinalpredictionmodelinpatientswithaneurysmalsubarachnoidhaemorrhage AT sneadem predictionoftwomonthmodifiedrankinscalewithanordinalpredictionmodelinpatientswithaneurysmalsubarachnoidhaemorrhage AT steyerberge predictionoftwomonthmodifiedrankinscalewithanordinalpredictionmodelinpatientswithaneurysmalsubarachnoidhaemorrhage AT sturkenboomm predictionoftwomonthmodifiedrankinscalewithanordinalpredictionmodelinpatientswithaneurysmalsubarachnoidhaemorrhage |