Predicting 28-Day Mortality in Subarachnoid Hemorrhage (SAHstdy)

Haseki Training and Research Hospital

Status: Completed

Conditions: Subarachnoid Hemorrhage, Aneurysmal

Treatments: Other: World Federation of Neurological Surgeons (WFNS) scale; Other: Hunt-Hess scale; Other: Ogilvy and Carter scale; Other: VASOGRADE scale; Other: modified Fisher scale; Other: Glasgow coma scale

Study type: Observational

Funder types: Other

Identifiers

NCT06563219

38-2024

Details and patient eligibility

About

The investigators investigated the predictive ability of clinical and radiological scores, including the Glasgow coma scale (GCS), Hunt-Hess, World Federation of Neurological Surgeons (WFNS), and modified Fisher scales, as well as combined clinical scores such as the VASOGRADE and Ogilvy-Carter rating scales, for 28-day mortality in patients presenting to the emergency department (ED) with non-traumatic subarachnoid hemorrhage (SAH). Specifically, we tested the hypothesis that combined clinical scores are more reliable and superior to non-combined clinical and radiological scores in predicting 28-day mortality in non-traumatic SAH.

Full description

Patients were divided into survivors and non-survivors, with surviving patients further categorized as either mobile or immobile based on the Glasgow outcome scale. Accordingly, patients who were dependent on daily support or in a coma were classified as immobile, whereas patients who had returned to normal life or were independent in their daily activities were classified as mobile. The demographic (age and sex), comorbidities (hypertension, diabetes mellitus [DM] and/or coronary artery disease [CAD]), vital signs (systolic blood pressure, heart rate, respiratory rate, and peripheral capillary oxygen saturation [sPO2]), and clinical assessment tools (GCS, Hunt Hess, WFNS, modified Fisher, VASOGRADE, and Ogilvy-Carter rating scales) on admission were compared between the groups to identify factors associated with 28-day mortality and neurological survival. Independent predictors of mortality were determined by multivariate logistic regression analysis of variables (demographic characteristics, clinical characteristics, and trauma scores) that differed significantly between survivors and non-survivors. An area under the curve (AUC) analysis was then conducted to identify which trauma score is the most reliable and superior predictor of mortality.

Enrollment: 451 patients

Sex: All

Ages: 18+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• patients (aged ≥ 18 years) who presented to the emergency department with non-traumatic Subarachnoid Hemorrhage between September 2020 and September 2023

Exclusion criteria

• patients younger than 18 years
• patients with missing information
• patients with traumatic SAH
• patients with subdural or epidural hemorrhage
• patients with concurrent ischemic stroke

Trial design

451 participants in 2 patient groups

Survivors

Description:

Survivors were defined as patients who were still alive after 28 days of admission to the emergency department.

Treatment:

Other: Glasgow coma scale

Other: VASOGRADE scale

Other: modified Fisher scale

Other: Ogilvy and Carter scale

Other: World Federation of Neurological Surgeons (WFNS) scale

Other: Hunt-Hess scale

Non-survivors

Description:

Non-survivors had passed away within 28 days of admission to the emergency department.

Treatment:

Other: Glasgow coma scale

Other: VASOGRADE scale

Other: modified Fisher scale

Other: Ogilvy and Carter scale

Other: World Federation of Neurological Surgeons (WFNS) scale

Other: Hunt-Hess scale