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An admission bioclinical score to predict 1-year outcomes in patients undergoing aneurysm coiling

Vincent Degos1, Christian C Apfel, Paola Sanchez

  • 1Department of Anesthesia and Perioperative Care, University of California, San Francisco, CA 94110, USA. degosv@anesthesia.ucsf.edu

Stroke
|February 25, 2012
PubMed

Insights

A new ABC score, integrating biomarkers and clinical data, accurately predicts 1-year outcomes for subarachnoid hemorrhage patients treated with coiling. This score outperforms existing methods for improved patient management.

Area of Science:

  • Neurology
  • Neurosurgery
  • Critical Care Medicine

Background:

  • Existing outcome prediction scores for subarachnoid hemorrhage (SAH) are not designed for endovascular treatment (coiling).
  • There is a need for a validated score to predict outcomes in patients undergoing endovascular coiling for SAH.

Purpose of the Study:

  • To develop and validate a predictive score for 1-year outcomes in patients with SAH treated with endovascular coiling.
  • To compare the performance of the new score against existing clinical scores.

Main Methods:

  • Developed an admission bioclinical score (ABC score) integrating Glasgow Coma Scale (GCS), troponin I, and S100β.
  • Compared the ABC score with GCS, World Federation of Neurosurgical Societies (WFNS), and Fisher scores using receiver operating characteristic (ROC) curves.
  • Validated the ABC score in an independent cohort of 526 patients over 1 year.

Main Results:

  • The ABC score independently associated Glasgow Coma Scale, S100β, and troponin with 1-year mortality.
  • In the derivation cohort, the ABC score achieved an ROC of 0.82, significantly outperforming GCS, WFNS, and Fisher scores.
  • In the validation cohort, the ABC score maintained superiority with an ROC of 0.76.

Conclusions:

  • The ABC score enhances 1-year outcome prediction at admission for patients with coiled SAH.
  • This study supports integrating biomarkers and clinical characteristics for improved outcome prediction in SAH.
  • The ABC score offers a valuable tool for managing patients with coiled SAH.
Abstract

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