Related Experiment Video
Updated: Jun 10, 2026
07:03
A Low Mortality Rat Model to Assess Delayed Cerebral Vasospasm After Experimental Subarachnoid Hemorrhage
Published on: January 17, 2013
Aneurysmal Subarachnoid Hemorrhage Risk Assessment Model Identifies Patients for Safe Early Discharge at Day 15-The
Eric E Kennison1,2, Nick M Murray3,4, Dave S Collingridge1,2,5
1Department of Neurosciences, Intermountain Medical Center, Murray, UT, USA.
Neurocritical Care
|March 29, 2025
Summary
This study developed a novel risk assessment model (RAM) to identify patients with aneurysmal subarachnoid hemorrhage (aSAH) who are unlikely to experience late complications. The "SAFE-SaH" model enables earlier discharge for low-risk patients, optimizing hospital resource utilization.
Area of Science:
- Neurosurgery
- Neurology
- Critical Care Medicine
Background:
- Aneurysmal subarachnoid hemorrhage (aSAH) frequently necessitates prolonged hospitalization (21 days) due to potential complications.
- Identifying patients at low risk for delayed complications can facilitate earlier discharge and optimize resource allocation.
Purpose of the Study:
- To develop and validate a risk assessment model (RAM) for predicting post-day-14 complications in aSAH patients.
- To identify candidates for early discharge from day 15 onwards based on early clinical data.
Main Methods:
- A retrospective analysis of 165 adult aSAH patients admitted to a Comprehensive Stroke Center (2017-2024).
- Data included demographics, aSAH severity grading (Hunt Hess Score, modified Fisher Score), and interventions.
- Binary logistic regression with leave-one-out cross-validation (LOOCV) was employed to build the RAM.
Main Results:
- The developed RAM, named "SAFE-SaH" (Sum of Vasopressors, Artery [MCA aneurysm], Fludrocortisone, EVD, Scale [mFS and HHS]), incorporated six key variables.
- The model demonstrated strong predictive performance with an AUC of 0.90, sensitivity of 94%, and negative predictive value of 91% for predicting complications after day 14.
- 54.5% of patients experienced complications during days 15-21, highlighting the need for accurate risk stratification.
Conclusions:
- The "SAFE-SaH" RAM is the first model utilizing early hospitalization data (first 14 days) to predict late complications in aSAH.
- The model's high sensitivity (94%) allows for reliable identification of patients unlikely to develop complications, supporting earlier discharge decisions.
- This tool can aid clinicians in optimizing patient disposition and managing hospital length of stay after aneurysmal subarachnoid hemorrhage.
Related Concept Videos
01:22Aneurysm IV: Nursing Management
Vigilant monitoring for aneurysm rupture is essential for patients undergoing aortic surgery.Preoperative Nursing ManagementContinuously monitor the patient for manifestations of aneurysm rupture, such as pallor, weakness, tachycardia, hypotension, abdominal, back, groin, or periumbilical pain, changes in consciousness, and a pulsating abdominal mass. Regularly assess the patient's peripheral pulses.Instruct the patient to consume a clear liquid diet the day before surgery and administer...
01:17Hemorrhagic Stroke l: Introduction
A hemorrhagic stroke is an acute neurological event that occurs when a weakened cerebral blood vessel ruptures, allowing blood to accumulate within or around the brain. The sudden release of blood forms a focal hematoma that increases intracranial pressure, displaces neural tissue, and can obstruct cerebrospinal fluid pathways. These effects may be compounded by intraventricular extension of the hemorrhage, cerebral edema, or compression of adjacent structures, all of which contribute to...
01:29Hemorrhagic Stroke ll: Pathophysiology
A hemorrhagic stroke develops when a cerebral blood vessel ruptures, allowing blood to escape into the surrounding brain tissue, as in intracerebral hemorrhage (ICH), or into the subarachnoid space, as in subarachnoid hemorrhage (SAH). Because the skull is a rigid compartment, the sudden presence of extravascular blood rapidly increases intracranial pressure and compresses adjacent neural structures, leading to immediate tissue injury and impaired cerebral perfusion.Mass Effect and Primary...