Prediction of 60-day case fatality after aneurysmal subarachnoid hemorrhage: external validation of a prediction model

Content Provider	Semantic Scholar
Author	Dijkland, Simone A. Roozenbeek, Bob Brouwer, Patricia Lingsma, Hester F. Dippel, Diederik Wj Vergouw, Leonie J. M. Vergouwen, Mervyn D. I. Jagt, M. Annerie Van Der
Copyright Year	2015
Abstract	OBJECTIVE External validation of prognostic models is crucial but rarely done. Our aim was to externally validate a prognostic model to predict 60-day case fatality after aneurysmal subarachnoid hemorrhage developed from the International Subarachnoid Aneurysm Trial in a retrospective unselected cohort of subarachnoid hemorrhage patients. DESIGN The model's predictors were age, aneurysm size, Fisher grade, and World Federation of Neurological Surgeons grade. Two versions of the model were validated: one with World Federation of Neurological Surgeons grade scored at admission and the other with World Federation of Neurological Surgeons grade at treatment decision. The outcome was 60-day case fatality. Performance of the model was assessed by studying discrimination, expressed by the area under the receiver operating characteristic curve, and calibration. SETTING University hospital. PATIENTS We analyzed data from 307 consecutive aneurysmal subarachnoid hemorrhage patients admitted between 2007 and 2011 (validation cohort). INTERVENTIONS None. MEASUREMENTS AND MAIN RESULTS The observed 60-day case fatality rate was 30.6%. Discrimination was good, and differed between the model with World Federation of Neurological Surgeons grade at treatment decision (area under the receiver operating characteristic curve, 0.89) and at admission (area under the receiver operating characteristic curve, 0.82). Mean predicted probabilities were lower than observed: 17.0% (model with World Federation of Neurological Surgeons grade at admission) and 17.7% (model with World Federation of Neurological Surgeons grade at treatment decision). CONCLUSIONS The model discriminated well between patients who died or survived within 60 days. In addition, we found that using World Federation of Neurological Surgeons grade at moment of treatment decision of the ruptured aneurysm improved model performance. However, since predicted probabilities were much lower than observed probabilities, the International Subarachnoid Aneurysm Trial prediction model needs to be adapted to be used in clinical practice.
Starting Page	P467
Ending Page	P467
Page Count	1
File Format	PDF HTM / HTML
PubMed reference number	26985635v1
Alternate Webpage(s)	https://doi.org/10.1097/CCM.0000000000001709
DOI	10.1097/CCM.0000000000001709
Journal	Critical care medicine
Volume Number	19
Language	English
Access Restriction	Open
Subject Keyword	Acids Brain Injuries CA1 field CA3 Stratum Lucidum Calcium Cerebral Ischemia Cessation of life Fever Gerbils Glial Fibrillary Acidic Protein Gliosis Heating Hypoxia-Ischemia, Brain Hypoxic-Ischemic Encephalopathy Microglia Nerve Degeneration Neuroglia PersonNameUse - assigned Reperfusion Injury Reperfusion Therapy Staining method TUBE,RECTAL,24FR,PLASTIC B#6510 Thermistors Transient Ischemic Attack Viola fluoro jade
Content Type	Text
Resource Type	Article