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Prediction of Outcome Using Quantified Blood Volume in Aneurysmal SAH
W E van der Steen1,2,3,4, H A Marquering5,2, L A Ramos5,6
1From the Departments of Biomedical Engineering and Physics (W.E.v.d.S., H.A.M., L.A.R., A.M.M.B.) w.e.vandersteen@amc.uva.nl.
AJNR. American Journal of Neuroradiology
|May 16, 2020
Summary
Quantifying blood volume in subarachnoid hemorrhage (SAH) improves clinical outcome prediction. A new model using total blood volume is more accurate than the modified Fisher scale for predicting SAH patient outcomes.
Area of Science:
- Neurosurgery
- Radiology
- Clinical Prediction Modeling
Background:
- Subarachnoid hemorrhage (SAH) patient outcomes correlate with blood volume, but current grading scales are imprecise.
- Accurate prediction of SAH clinical outcomes is crucial for patient management.
Purpose of the Study:
- To develop and validate prediction models for SAH clinical outcomes.
- To incorporate quantified blood volumes as predictors.
- To compare the performance of blood volume-based models against the modified Fisher scale.
Main Methods:
- Logistic regression was used with clinical and radiologic predictors.
- An algorithm quantified total blood volume; blood was manually classified (cisternal, intraventricular, intraparenchymal).
- Models were validated using R², C-statistic, and calibration plots, comparing total blood volume, location-specific volumes, and the modified Fisher scale.
Main Results:
- Total blood volume, neurological condition, age, aneurysm size, and cardiovascular disease history were significant predictors.
- The total blood volume model demonstrated high predictive accuracy (R² = 56%) and discrimination (C-statistic = 0.89).
- Blood volume models outperformed the modified Fisher scale (R² = 45%, C-statistic = 0.85).
Conclusions:
- A prediction model using total blood volume offers high accuracy for SAH clinical outcomes.
- This blood volume-based model surpasses the predictive capability of the modified Fisher scale.
- Quantified blood volume is a valuable predictor for SAH patient outcomes.
