title: An admission bioclinical score to predict 1-year outcomes in patients undergoing aneurysm coiling.
abstract: OBJECTIVE
  A number of scores were developed to predict outcomes after clipping for subarachnoid hemorrhages, yet there is no score for patients undergoing endovascular treatment. Our goal was to develop, compare, and validate a predictive score for 1-year outcomes in patients with coiled subarachnoid hemorrhage.
  
  
  METHODS
  We studied 526 patients for 1 year after intensive care unit discharge. We developed an admission bioclinical score (ABC score), which integrated biomarkers such as troponin I and S100β, with the Glasgow Coma Scale. Using the receiver operating characteristic curve (95% CI), the ABC score was compared with the Glasgow Coma Scale, World Federation of Neurosurgical Societies score, and Fisher score in the derivation cohort and further validated in an independent cohort.
  
  
  RESULTS
  In the derivation cohort (from 2003-2007, n=368), multivariate logistic regression analysis showed that only Glasgow Coma Scale (P<0.001), high S100β (P<0.001), and high troponin (P<0.02) were independently associated with 1-year mortality. Troponin, S100β, and Glasgow Coma Scale were thus integrated to derive the ABC score. In the derivation cohort, the ABC score reached an receiver operating characteristic curve of 0.82 (0.77-0.88, P<0.001) and was significantly greater than the receiver operating characteristic curves of the Glasgow Coma Scale, World Federation of Neurosurgical Societies, and Fisher scores for predicting 1-year mortality. In the validation cohort (from 2008-2009, n=158), the ABC score's receiver operating characteristic curve of 0.76 (0.67-0.86, P<0.001) remained superior to the 3 other scores for predicting 1-year mortality.
  
  
  CONCLUSIONS
  The ABC score improves 1-year outcome prediction at admission for patients with coiled subarachnoid hemorrhage. Our study provides large cohort-based evidence supporting integration of individual biomarkers and clinical characteristics to predict outcomes. Clinical Trial Registration- URL: www.clinicaltrials.gov. Unique identifier: NCT01357057.
authors.affiliation: Department of Anesthesia and Perioperative Care, University of California, San Francisco, CA 94110, USA. degosv@anesthesia.ucsf.edu
authors.forename: Vincent
authors.initials: V
authors.lastname: Degos
authors.forename: Christian C
authors.initials: CC
authors.lastname: Apfel
authors.forename: Paola
authors.initials: P
authors.lastname: Sanchez
authors.forename: Chantal
authors.initials: C
authors.lastname: Colonne
authors.forename: Isabelle
authors.initials: I
authors.lastname: Renuit
authors.forename: Frédéric
authors.initials: F
authors.lastname: Clarençon
authors.forename: Aurélien
authors.initials: A
authors.lastname: Nouet
authors.forename: Anne Laure
authors.initials: AL
authors.lastname: Boch
authors.forename: Tony
authors.initials: T
authors.lastname: Pourmohamad
authors.forename: Helen
authors.initials: H
authors.lastname: Kim
authors.forename: Pierre Antoine
authors.initials: PA
authors.lastname: Gourraud
authors.forename: William L
authors.initials: WL
authors.lastname: Young
authors.forename: Louis
authors.initials: L
authors.lastname: Puybasset
mesh_terms: D000328:Adult; D015415:Biomarkers / Q000097:blood; D015331:Cohort Studies; D057510:Endovascular Procedures; D005260:Female; D005500:Follow-Up Studies; D015600:Glasgow Coma Scale; D006801:Humans; D002532:Intracranial Aneurysm / Q000097:blood / Q000175:diagnosis / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures; D009414:Nerve Growth Factors / Q000097:blood; D011237:Predictive Value of Tests; D011300:Preoperative Care; D011379:Prognosis; D011446:Prospective Studies; D012189:Retrospective Studies; D064568:S100 Calcium Binding Protein beta Subunit; D009418:S100 Proteins / Q000097:blood; D012720:Severity of Illness Index; D013345:Subarachnoid Hemorrhage / Q000097:blood / Q000175:diagnosis / Q000601:surgery*; D016896:Treatment Outcome; D019210:Troponin I / Q000097:blood
chemical_list: D015415:Biomarkers; D009414:Nerve Growth Factors; D064568:S100 Calcium Binding Protein beta Subunit; D009418:S100 Proteins; D019210:Troponin I