Observational studyNeurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology2023
The post-resuscitation VASOGRADE: a more accurate scale to predict delayed cerebral ischemia after aneurysmal subarachnoid hemorrhage.
Observational study in Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
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3 citing papers in PubMed.
- Grading Scores for Identifying Patients at Risk of Delayed Cerebral Ischemia and Neurological Outcome in Spontaneous Subarachnoid Hemorrhage: A Comparison of Receiver Operator Curve Analysis.Neurocritical care · 2025Article
- Serum uric acid is associated with shunt dependent hydrocephalus of aneurysmal subarachnoid hemorrhage patients.Neurosurgical review · 2025Article
- Trajectory of mean platelet volume changes after aneurysmal subarachnoid hemorrhage in patients with or without delayed cerebral ischemia.Scientific reports · 2024Observational
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4 authors.
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Abstract
backgroundPredicting the occurrence of delayed cerebral ischemia (DCI) after aneurysmal subarachnoid hemorrhage is of interest to adjust the level of care. The VASOGRADE, a simple grading scale using admission World Federation of Neurosurgical Societies (WFNS) grading score and modified Fisher scale (mFS) on first CT scan, could help to select patients at risk of DCI. However, using data after initial resuscitation (initial complication treatment, aneurysm exclusion) may be more relevant.
methodsWe calculated a post-resuscitation VASOGRADE (prVG) using WFNS grade and mFS after early brain injury treatment and aneurysm exclusion (or at day 3). Patients were categorized as green, yellow, or red.
resultsUsing our prospective observational registry, 566 patients were included in the study. Two hundred six (36.4%) were classified as green, 208 (36.7%) as yellow, and 152 (26.9%) as red, and DCI was experienced in 22 (10.7%), 67 (32.2%), and 45 (29.6%) cases respectively. Patients classified as yellow had higher risk of developing DCI (OR 3.94, 95% CI 2.35-6.83). Risk was slightly lower in red patients (OR 3.49, 95% CI 2.00-6.24). The AUC for prediction was higher with prVG (0.62, 95% CI 0.58-0.67) than with VASOGRADE (0.56, 95% CI 0.51-0.60) (p < 0.01).
conclusionBy using simple clinical and radiological scale evaluated at subacute stage, prVG is more accurate to predict the occurrence of DCI.
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