Prediction of 60 day case-fatality after aneurysmal subarachnoid haemorrhage: results from the International Subarachnoid Aneurysm Trial (ISAT).
Aneurysmal subarachnoid haemorrhage (aSAH) is a devastating event with substantial case-fatality. Our purpose was to examine which clinical and neuro-imaging characteristics, available on admission, predict 60 day case-fatality in aSAH and to evaluate performance of our prediction model. We performe...
| Main Authors: | , , , , , , , , , |
|---|---|
| Format: | Journal article |
| Language: | English |
| Published: |
2010
|
| _version_ | 1797078479551856640 |
|---|---|
| author | Risselada, R Lingsma, H Bauer-Mehren, A Friedrich, C Molyneux, A Kerr, R Yarnold, J Sneade, M Steyerberg, E Sturkenboom, M |
| author_facet | Risselada, R Lingsma, H Bauer-Mehren, A Friedrich, C Molyneux, A Kerr, R Yarnold, J Sneade, M Steyerberg, E Sturkenboom, M |
| author_sort | Risselada, R |
| collection | OXFORD |
| description | Aneurysmal subarachnoid haemorrhage (aSAH) is a devastating event with substantial case-fatality. Our purpose was to examine which clinical and neuro-imaging characteristics, available on admission, predict 60 day case-fatality in aSAH and to evaluate performance of our prediction model. We performed a secondary analysis of patients enrolled in the International Subarachnoid Aneurysm Trial (ISAT), a randomised multicentre trial to compare coiling with clipping in aSAH patients. Multivariable logistic regression analysis was used to develop a prognostic model to estimate the risk of dying within 60 days from aSAH based on clinical and neuro-imaging characteristics. The model was internally validated with bootstrapping techniques. The study population comprised of 2,128 patients who had been randomised to either endovascular coiling or neurosurgical clipping. In this population 153 patients (7.2%) died within 60 days. World Federation of Neurosurgical Societies (WFNS) grade was the most important predictor of case-fatality, followed by age, lumen size of the aneurysm and Fisher grade. The model discriminated reasonably between those who died within 60 days and those who survived (c statistic = 0.73), with minor optimism according to bootstrap re-sampling (optimism corrected c statistic = 0.70). Several strong predictors are available to predict 60 day case-fatality in aSAH patients who survived the early stage up till a treatment decision; after external validation these predictors could eventually be used in clinical decision making. |
| first_indexed | 2024-03-07T00:32:26Z |
| format | Journal article |
| id | oxford-uuid:804ad54e-91bb-481e-b44a-ed47f0f76f10 |
| institution | University of Oxford |
| language | English |
| last_indexed | 2024-03-07T00:32:26Z |
| publishDate | 2010 |
| record_format | dspace |
| spelling | oxford-uuid:804ad54e-91bb-481e-b44a-ed47f0f76f102022-03-26T21:22:16ZPrediction of 60 day case-fatality after aneurysmal subarachnoid haemorrhage: results from the International Subarachnoid Aneurysm Trial (ISAT).Journal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:804ad54e-91bb-481e-b44a-ed47f0f76f10EnglishSymplectic Elements at Oxford2010Risselada, RLingsma, HBauer-Mehren, AFriedrich, CMolyneux, AKerr, RYarnold, JSneade, MSteyerberg, ESturkenboom, MAneurysmal subarachnoid haemorrhage (aSAH) is a devastating event with substantial case-fatality. Our purpose was to examine which clinical and neuro-imaging characteristics, available on admission, predict 60 day case-fatality in aSAH and to evaluate performance of our prediction model. We performed a secondary analysis of patients enrolled in the International Subarachnoid Aneurysm Trial (ISAT), a randomised multicentre trial to compare coiling with clipping in aSAH patients. Multivariable logistic regression analysis was used to develop a prognostic model to estimate the risk of dying within 60 days from aSAH based on clinical and neuro-imaging characteristics. The model was internally validated with bootstrapping techniques. The study population comprised of 2,128 patients who had been randomised to either endovascular coiling or neurosurgical clipping. In this population 153 patients (7.2%) died within 60 days. World Federation of Neurosurgical Societies (WFNS) grade was the most important predictor of case-fatality, followed by age, lumen size of the aneurysm and Fisher grade. The model discriminated reasonably between those who died within 60 days and those who survived (c statistic = 0.73), with minor optimism according to bootstrap re-sampling (optimism corrected c statistic = 0.70). Several strong predictors are available to predict 60 day case-fatality in aSAH patients who survived the early stage up till a treatment decision; after external validation these predictors could eventually be used in clinical decision making. |
| spellingShingle | Risselada, R Lingsma, H Bauer-Mehren, A Friedrich, C Molyneux, A Kerr, R Yarnold, J Sneade, M Steyerberg, E Sturkenboom, M Prediction of 60 day case-fatality after aneurysmal subarachnoid haemorrhage: results from the International Subarachnoid Aneurysm Trial (ISAT). |
| title | Prediction of 60 day case-fatality after aneurysmal subarachnoid haemorrhage: results from the International Subarachnoid Aneurysm Trial (ISAT). |
| title_full | Prediction of 60 day case-fatality after aneurysmal subarachnoid haemorrhage: results from the International Subarachnoid Aneurysm Trial (ISAT). |
| title_fullStr | Prediction of 60 day case-fatality after aneurysmal subarachnoid haemorrhage: results from the International Subarachnoid Aneurysm Trial (ISAT). |
| title_full_unstemmed | Prediction of 60 day case-fatality after aneurysmal subarachnoid haemorrhage: results from the International Subarachnoid Aneurysm Trial (ISAT). |
| title_short | Prediction of 60 day case-fatality after aneurysmal subarachnoid haemorrhage: results from the International Subarachnoid Aneurysm Trial (ISAT). |
| title_sort | prediction of 60 day case fatality after aneurysmal subarachnoid haemorrhage results from the international subarachnoid aneurysm trial isat |
| work_keys_str_mv | AT risseladar predictionof60daycasefatalityafteraneurysmalsubarachnoidhaemorrhageresultsfromtheinternationalsubarachnoidaneurysmtrialisat AT lingsmah predictionof60daycasefatalityafteraneurysmalsubarachnoidhaemorrhageresultsfromtheinternationalsubarachnoidaneurysmtrialisat AT bauermehrena predictionof60daycasefatalityafteraneurysmalsubarachnoidhaemorrhageresultsfromtheinternationalsubarachnoidaneurysmtrialisat AT friedrichc predictionof60daycasefatalityafteraneurysmalsubarachnoidhaemorrhageresultsfromtheinternationalsubarachnoidaneurysmtrialisat AT molyneuxa predictionof60daycasefatalityafteraneurysmalsubarachnoidhaemorrhageresultsfromtheinternationalsubarachnoidaneurysmtrialisat AT kerrr predictionof60daycasefatalityafteraneurysmalsubarachnoidhaemorrhageresultsfromtheinternationalsubarachnoidaneurysmtrialisat AT yarnoldj predictionof60daycasefatalityafteraneurysmalsubarachnoidhaemorrhageresultsfromtheinternationalsubarachnoidaneurysmtrialisat AT sneadem predictionof60daycasefatalityafteraneurysmalsubarachnoidhaemorrhageresultsfromtheinternationalsubarachnoidaneurysmtrialisat AT steyerberge predictionof60daycasefatalityafteraneurysmalsubarachnoidhaemorrhageresultsfromtheinternationalsubarachnoidaneurysmtrialisat AT sturkenboomm predictionof60daycasefatalityafteraneurysmalsubarachnoidhaemorrhageresultsfromtheinternationalsubarachnoidaneurysmtrialisat |