The eSAH score: a simple practical predictive model for SAH mortality and outcomes

Area of Science:

• Neurology
• Radiology
• Critical Care Medicine

Background:

• Aneurysmal subarachnoid hemorrhage (aSAH) is a critical condition with high rates of mortality and morbidity.
• Predicting outcomes such as mortality, delayed cerebral ischemia (DCI), and functional status is crucial for patient management.

Purpose of the Study:

• To develop and validate a simple, quantifiable scoring system to predict mortality, DCI, and modified Rankin Scale (mRS) outcomes in patients with aSAH.
• To utilize readily available admission data, including subarachnoid hemorrhage volume (SAHV) from CT scans.

Main Methods:

• Retrospective analysis of 277 aSAH patients.
• Development of a mathematical radiographic model (SAHV) using the ABC/2 formula on noncontrast CT.
• Multivariate logistic regression analysis to identify predictors and develop the enhanced SAH (eSAH) scoring system.

Main Results:

• Age, Glasgow Coma Scale score, and SAHV were significant predictors of mRS outcomes, DCI, and in-hospital mortality.
• The eSAH score, ranging from 0 to 5, demonstrated strong predictive power for mRS outcomes (AUC=0.89), DCI (AUC=0.75), and mortality (AUC=0.88).

Conclusions:

• The proposed eSAH score is a simple, quantitative model that effectively predicts mortality and outcomes in aSAH patients.
• The score integrates SAHV, Glasgow Coma Scale score, and age, offering a practical tool for clinical assessment.
• Further validation in a larger cohort is planned to confirm these findings.