Improving the models for prognosis of aneurysmal subarachnoid hemorrhage with the neutrophil-to-albumin ratio

Frontiers in Neurology

Neurology

Yu Zhang¹  Zheran Liu²  Yiyan Pei²  Yan He²  Lu Ma³  Chao You³  Renjie Zhang³  Fang Fang³  Jiayi Yu⁴ 

[1] Center for Evidence-Based Medical and Clinical Research, Affiliated Hospital of Chengdu University, Chengdu, Sichuan, China;Department of Biotherapy, Cancer Center, West China Hospital of Sichuan University, Chengdu, Sichuan, China;Department of Neurosurgery, West China Hospital of Sichuan University, Chengdu, Sichuan, China;School of Medical and Life Sciences, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China;

关键词: neutrophil-to-albumin ratio;    intracranial aneurysm;    subarachnoid hemorrhage;    mortality;    prediction model;   

DOI  :  10.3389/fneur.2023.1078926

 received in 2022-10-24, accepted in 2023-03-09,  发布年份 2023

来源: Frontiers

【 摘 要 】

ObjectiveMany peripheral inflammatory markers were reported to be associated with the prognosis of aneurysmal subarachnoid hemorrhage (aSAH). We aimed to identify the most promising inflammatory factor that can improve existing predictive models.MethodsThe study was based on data from a 10 year retrospective cohort study at Sichuan University West China Hospital. We selected the well-known SAFIRE and Subarachnoid Hemorrhage International Trialists’ (SAHIT) models as the basic models. We compared the performance of the models after including the inflammatory markers and that of the original models. The developed models were internally and temporally validated.ResultsA total of 3,173 patients were included in this study, divided into the derivation cohort (n = 2,525) and the validation cohort (n = 648). Most inflammatory markers could improve the SAH model for mortality prediction in patients with aSAH, and the neutrophil-to-albumin ratio (NAR) performed best among all the included inflammatory markers. By incorporating NAR, the modified SAFIRE and SAHIT models improved the area under the receiver operator characteristics curve (SAFIRE+NAR vs. SAFIRE: 0.794 vs. 0.778, p = 0.012; SAHIT+NAR vs. SAHIT: 0.831 vs. 0.819, p = 0.016) and categorical net reclassification improvement (SAFIRE+NAR: 0.0727, p = 0.002; SAHIT+NAR: 0.0810, p < 0.001).ConclusionThis study illustrated that among the inflammatory markers associated with aSAH prognosis, NAR could improve the SAFIRE and SAHIT models for 3 month mortality of aSAH.

【 授权许可】

Unknown   
Copyright © 2023 Zhang, Zhang, Liu, Pei, He, Yu, You, Ma and Fang.