• CNS Neurosci Ther · Oct 2019

    Observational Study

    New risk score of the early period after spontaneous subarachnoid hemorrhage: For the prediction of delayed cerebral ischemia.

    • Yuan-Jian Fang, Shu-Hao Mei, Jia-Nan Lu, Yi-Ke Chen, Zhao-Hui Chai, Xiao Dong, Camila Araujo, Cesar Reis, Jian-Min Zhang, and Sheng Chen.
    • Department of Neurosurgery, The Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China.
    • CNS Neurosci Ther. 2019 Oct 1; 25 (10): 1173-1181.

    Background And PurposeThe aim of this study is to identify the early predictors for delayed cerebral ischemia (DCI) and develop a risk stratification score by focusing on the early change after aneurysmal subarachnoid hemorrhage (aSAH).MethodsThe study retrospectively reviewed aSAH patients between 2014 and 2015. Risk factors within 72 hours after aSAH were included into univariable and multivariable logistic regression analysis to screen the independent predictors for DCI and to design a risk stratification score.ResultsWe analyzed 702 aSAH patients; four predictors were retained from the final multivariable analysis: World Federation of Neurosurgical Societies scale (WFNS; OR = 4.057, P < .001), modified Fisher Scale (mFS; OR = 2.623, P < .001), Subarachnoid Hemorrhage Early Brain Edema Score (SEBES; OR = 1.539, P = .036), and intraventricular hemorrhage (IVH; OR = 1.932, P = .002). According to the regression coefficient, we created a risk stratification score ranging from 0 to 7 (WFNS = 3, mFS = 2, SEBES = 1, and IVH = 1). The new score showed a significantly higher area under curve (0.785) compared with other scores (P < .001).ConclusionThe early DCI score provides a practical method at the early 72 hours after aSAH to predict DCI.© 2019 The Authors. CNS Neuroscience & Therapeutics Published by John Wiley & Sons Ltd.

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