Construction and evaluation of a near-term prognostic model for aneurysmal subarachnoid hemorrhage based on arterial spin labeling:a prospective study
Objective To develop a short-term prognostic model for aneurysmal subarachnoid hemorrhage(aSAH)using arterial spin labeling and to assess the model's efficacy.Methods A total of 107 aSAH patients from our hospital underwent arterial spin labeling examination and were prospectively selected as study subjects.Patients were classified into good and poor prognosis groups based on their modified Rankin scale scores at 90 days post-discharge.Comparisons between the two groups were conducted for age,Hunt-Hess scale score,modified Fisher scale score,Glasgow coma scale(GCS)score,and blood cell parameters.Risk factors for the aSAH prognosis were then analyzed using LASSO-Logistic regression.A prognostic model was developed,and its effectiveness was evaluated using ROC curves,calibration curves,and decision curve analysis.Results Compared to the good prognosis group,the poor prognosis group exhibited higher levels of age,Hunt-Hess scale score,modified Fisher scale score,neutrophils,lymphocytes,neutrophils/lymphocytes and systemic immune inflammation index(P<0.05).Conversely,the GCS score,platelets/lymphocytes,ipsilateral regional cerebral blood flow(rCBF)values,and rCBF ratio were lower than those in the good prognosis group(P<0.05).LASSO-Logistic regression analysis revealed that age>44 years old and a Hunt-Hess scale score of 3-5 were independent risk factors for the prognosis of aSAH(P<0.05),while a GCS score>9 and an rCBF ratio>0.66 were independent protective factors for the prognosis of aSAH(P<0.05).The model A,consisting of age,Hunt-Hess scale score,and GCS score,had an area under the ROC curve of 0.961,which was not statistically significantly different from the area under the ROC curve of model B,consisting of age,Hunt-Hess scale score,GCS score,and rCBF ratio(0.981)(P>0.05).While the calibration curve of model A moderately overlapped with the ideal curve,model B exhibited a high overlap with the ideal curve.Moreover,the mean absolute error value was higher in model A(0.042)than in model B(0.014).The net benefit of model B outweighed that of model A across most of the risk threshold range.Conclusion The age,Hunt-Hess scale score,and GCS score of aSAH patients are significant in predicting poor prognosis.Incorporating the rCBF ratio into the model was found to enhance its value in assessing poor prognosis in aSAH patients.
国家科技期刊平台
NSTL
万方数据
维普
