Outcome prediction in severe aneurysmal subarachnoid hemorrhage utilizing the Full Outline of Unresponsiveness Scale

doi:10.3969/j.issn.1006-7795.2018.01.006

Abstract

Abstract: Objective To explore the value of the Full Outline of Unresponsiveness Scale (FOUR) in the outcome prediction of severe aneurysmal subarachnoid hemorrhage (aSAH).Methods This is a prospective, observational cohort study. Patients who were diagnosed as aSAH with a World Federation of Neurosurgical Societies (WFNS) grade of Ⅳ or Ⅴ were consecutively included after aggressive treatment,and they were transferred to our intensive care unit for evaluation by FOUR and Glasgow Coma Scale (GCS). The follow-up was performed at 3 months after SAH ictus, based on the Modified Rankin Scale (mRS). The univariate analysis and multivariate logistic regression were applied for statistical evaluation. The receiver operating characteristic curves for the outcome prediction of FOUR and GCS scores were drawn, with area under curves (AUC) calculated, in the meanwhile, their sensitivity (SEN), specificity (SPE), positive predictive values (PPV), and negative predictive values (NPV) were assessed.Results A total of 34 patients were enrolled. Only FOUR scores were identified to be the independent risk factor for poor outcome (mRS4 to 6) (odds ratio 0.22 95% confidence interval 0.01-0.75,P<0.05). Moreover, its Scores (AUC=0.87, SEN=0.91, SPE=0.85, PPV=0.88, NPV=0.84) were all better than those of GCS scores (AUC 0.79, SEN 0.71, SPE 0.79, PPV 0.79, NPV 0.69, respectively).Conclusion In comparison with GCS scores, FOUR scale performs better in the postoperative outcome prediction in severe aSAH.

Key words: aneurysmal subarachnoid hemorrhage, critical illness, Full Outline of Unresponsiveness Scale, Glasgow Coma Scale, prognosis

CLC Number:

R743.35

Zhao Jingwei, Luo Xuying, Xu Ming, Shi Guangzhi, Zhou Jianxin. Outcome prediction in severe aneurysmal subarachnoid hemorrhage utilizing the Full Outline of Unresponsiveness Scale[J]. Journal of Capital Medical University, 2018, 39(1): 28-34.

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URL: https://journal03.magtech.org.cn/Jweb_sdykdxxb/EN/10.3969/j.issn.1006-7795.2018.01.006

https://journal03.magtech.org.cn/Jweb_sdykdxxb/EN/Y2018/V39/I1/28

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