title: Predictive model for patients with poor-grade subarachnoid haemorrhage in 30-day observation: a 9-year cohort study.
abstract: OBJECTIVE
  The purpose of this study was to identify prognostic factors and build the predictive model based on poor-grade subarachnoid haemorrhage (SAH) population received only supportive symptomatic treatment.
  
  
  METHODS
  Prospective observational cohort study.
  
  
  METHODS
  Intensive care unit at the Clinical Department of Neurology.
  
  
  METHODS
  A total of 101 patients with spontaneous SAH disqualified from neurosurgical operative treatment due to poor clinical condition. Data were collected over a 9-year period.
  
  
  METHODS
  Unfavourable outcome was defined as a modified Rankin Score ≥ 5 at 30 days of observation.
  
  
  RESULTS
  Multivariable logistic regression analysis indicated the World Federation of Neurosurgical Societies Scale score, increasing age, Fisher grade and admission leucocytosis as independent predictive factors. The proposed scale subdivides the study population into four prognostic groups with significantly different outcomes: grade I: probability of favourable outcome 89.9%; grade II: 47.5%; grade III: 4.2%; grade IV: 0%. The receiver operating characteristic (ROC) curve for the prediction of outcome performed by the new scale had an area under the curve (AUC)=0.910 (excellent accuracy).
  
  
  CONCLUSIONS
  Unfavourable outcome in non-operated patients with poor-grade SAH is strongly predicted by traditional unmodifiable factors such as age, amount of bleeding in CT, level of consciousness as well as leucocytosis. A new predictive scale based on the above parameters seems to reliably predict the outcome and may contribute to more effective planning of therapeutic management in patients with poor-grade SAH.
authors.affiliation: Department of Neurology, Medical University of Lublin, Poland.
authors.forename: Sebastian
authors.initials: S
authors.lastname: Szklener
authors.affiliation: Department of Neurology, Medical University of Lublin, Poland.
authors.forename: Anna
authors.initials: A
authors.lastname: Melges
authors.affiliation: Department of Neurology, Medical University of Lublin, Poland.
authors.forename: Agnieszka
authors.initials: A
authors.lastname: Korchut
authors.affiliation: Department of Nephrology, Medical University of Lublin, Poland.
authors.forename: Wojciech
authors.initials: W
authors.lastname: Zaluska
authors.affiliation: Department of Neurosurgery, Medical University of Lublin, Poland.
authors.forename: Tomasz
authors.initials: T
authors.lastname: Trojanowski
authors.affiliation: Department of General Ophthalmology, Medical University of Lublin, Poland.
authors.forename: Robert
authors.initials: R
authors.lastname: Rejdak
authors.affiliation: Department of Neurology, Medical University of Lublin, Poland.
authors.forename: Konrad
authors.initials: K
authors.lastname: Rejdak
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D003422:Critical Care; D005260:Female; D015600:Glasgow Coma Scale; D006801:Humans; D007964:Leukocytosis / Q000175:diagnosis; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011446:Prospective Studies; D013345:Subarachnoid Hemorrhage / Q000097:blood / Q000175:diagnosis* / Q000401:mortality / Q000628:therapy*; D055815:Young Adult
keywords: NEUROSURGERY