ArticleActa neurochirurgica2025
Outcome prediction in aneurysmal subarachnoid hemorrhage with world federation of neurological societies grade V (OPAS-V).
Article in Acta neurochirurgica, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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2 citing papers in PubMed.
- Longitudinal trajectories of functional outcome following aneurysmal subarachnoid hemorrhage: a retrospective study.Critical care (London, England) · 2026Article
- Acute-phase bypass surgery for ruptured intracranial aneurysm: Selection criteria in the endovascular era.Surgical neurology international · 2026Article
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13 authors.
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Abstract
backgroundAneurysmal subarachnoid hemorrhage (aSAH) with World Federation of Neurological Societies (WFNS) grade V has a high mortality rate and poor prognosis. Some patients with WFNS grade V aSAH have had good outcomes after aggressive treatment; however, outcome predictions based on routine examinations and findings obtained at admission are yet to be reported. This study aimed to develop a decision tree model for predicting outcomes of patients with WFNS grade V aSAH to aid decision-making for treatment strategy.
methodA multicenter study with retrospective and prospective data collected from 201 (derivation cohort) and 26 (validation cohort) patients with WFNS grade V aSAH, respectively, was conducted. Clinical outcomes were divided into good (Modified Rankin Scale [mRS] score at the time of discharge: 0-2) and poor (mRS score: 3-6) outcomes. A decision tree model was developed for the derivation cohort using the classification and regression tree method with clinical data including laboratory findings; it was named OPAS-V (Outcome Prediction in Aneurysmal Subarachnoid hemorrhage with WFNS grade V). The performance of the model was evaluated by area under the curve (AUC) and overall accuracy in both cohorts.
resultsOPAS-V comprised 3 metrics; the percentage of lymphocytes (< 49.9% or not), age (> 50 yrs or not), and glucose to potassium ratio (≥ 3.2 or not). The model achieved an AUC of 0.828 (95% confidence interval: 0.712-0.944) and overall accuracy of 0.930. Moreover, the model performed well in the validation cohort with an AUC of 0.727 (95% confidence interval: 0.441-1) and overall accuracy of 0.885.
conclusionsThis study developed the first decision tree model for predicting outcomes of patients with WFNS grade V aSAH, based on simple findings obtained at admission. This may aid clinicians in determining treatment strategies for severe conditions such as WFNS grade V aSAH.
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