Predicting postacute phase anaemia after aneurysmal subarachnoid haemorrhage: nomogram development and validation

Area of Science:

• Neurology
• Hematology
• Medical Informatics

Background:

• Anaemia is a frequent and severe complication following aneurysmal subarachnoid haemorrhage (aSAH).
• Early intervention for anaemia in aSAH patients is beneficial, but a validated clinical tool is lacking.
• Current clinical practice lacks a method to synthesize complex patient features for anaemia risk assessment in aSAH.

Purpose of the Study:

• To develop a novel nomogram for predicting post-acute phase anaemia in patients with aSAH.
• To externally validate the developed nomogram in independent patient cohorts.
• To provide a practical clinical instrument for assessing individual anaemia risk post-aSAH.

Main Methods:

• A nomogram was developed using demographic, clinical, imaging, and laboratory data from 456 aSAH patients.
• External validation was performed on 220 patients from a separate hospital, with prospective validation on 13 patients.
• Model performance was assessed using concordance statistics (c-statistic) and calibration plots.

Main Results:

• The nomogram incorporated variables such as age, treatment type, baseline haemoglobin, glucose, inflammatory score, GCS, aneurysm size, PT, and heart rate.
• The model achieved a c-statistic of 0.910 in the validation cohort with satisfactory calibration.
• The predictive model demonstrated an 84% success rate in forward-looking forecasts, indicating clinical utility.

Conclusions:

• The developed and validated nomogram accurately predicts individualized anaemia risk in aSAH patients.
• This tool can assist clinicians in planning proactive treatment strategies for aSAH.
• The nomogram offers potential for improved management of anaemia complications in aSAH.