Background:Rebleeding can cause a catastrophic outcome after aneurysmal subarachnoid hemorrhage.A clinical+morphology nomogram was promoted in our previous study to assist in discriminating the rupture intracranial an...Background:Rebleeding can cause a catastrophic outcome after aneurysmal subarachnoid hemorrhage.A clinical+morphology nomogram was promoted in our previous study to assist in discriminating the rupture intracranial aneurysms(RIAs)with a high risk of rebleeding.The aim of this study was to validate the predictive accuracy of this nomogram model.Method:The patients with RIAs in two medical centers from December 2020 to September 2021 were retrospectively reviewed,whose clinical and morphological parameters were collected.The Cox regression model was employed to identify the risk factors related to rebleeding after their admission.The predicting accuracy of clinical+morphological nomogram,ELAPSS score and PHASES score was compared based on the area under the curves(AUCs).Results:One hundred thirty-eight patients with RIAs were finally included in this study,20 of whom suffering from rebleeding after admission.Hypertension(hazard ratio(HR),2.54;a confidence interval of 95%(CI),1.01-6.40;P=0.047),bifurcation(HR,3.88;95%CI,1.29-11.66;P=0.016),and AR(HR,2.68;95%CI,1.63-4.41;P<0.001)were demonstrated through Cox regression analysis as the independent risk factors for rebleeding after admission.The clinical+morphological nomogram had the highest predicting accuracy(AUC,0.939,P<0.01),followed by the bifurcation(AUC,0.735,P=0.001),AR(AUC,0.666,P=0.018),and ELAPSS score(AUC,0.682,P=0.009).Hypertension(AUC,0.693,P=0.080)or PHASES score(AUC,0.577,P=0.244)could not be used to predict the risk of rebleeding after admission.The calibration curve for the probability of rebleeding showed a good agreement between the prediction through clinical+morphological nomogram and actual observation.Conclusion:Hypertension,bifurcation site,and AR were independent risk factors related to the rebleeding of RIAs after admission.The clinical+morphological nomogram could help doctors to identify the high-risk RIAs with a high predictive accuracy.展开更多
基金the projects of National Natural Science Foundation of China(Grant Nos.82071296,81471210,and 81671129)"Major special projects in the 13th five-year plan"(Grant No.2016YFC1301800)+1 种基金"Major special projects in the 14th five-year plan"(Grant No.2021YFC2501100)The sponsors had no role in the design or conduct of this research.
文摘Background:Rebleeding can cause a catastrophic outcome after aneurysmal subarachnoid hemorrhage.A clinical+morphology nomogram was promoted in our previous study to assist in discriminating the rupture intracranial aneurysms(RIAs)with a high risk of rebleeding.The aim of this study was to validate the predictive accuracy of this nomogram model.Method:The patients with RIAs in two medical centers from December 2020 to September 2021 were retrospectively reviewed,whose clinical and morphological parameters were collected.The Cox regression model was employed to identify the risk factors related to rebleeding after their admission.The predicting accuracy of clinical+morphological nomogram,ELAPSS score and PHASES score was compared based on the area under the curves(AUCs).Results:One hundred thirty-eight patients with RIAs were finally included in this study,20 of whom suffering from rebleeding after admission.Hypertension(hazard ratio(HR),2.54;a confidence interval of 95%(CI),1.01-6.40;P=0.047),bifurcation(HR,3.88;95%CI,1.29-11.66;P=0.016),and AR(HR,2.68;95%CI,1.63-4.41;P<0.001)were demonstrated through Cox regression analysis as the independent risk factors for rebleeding after admission.The clinical+morphological nomogram had the highest predicting accuracy(AUC,0.939,P<0.01),followed by the bifurcation(AUC,0.735,P=0.001),AR(AUC,0.666,P=0.018),and ELAPSS score(AUC,0.682,P=0.009).Hypertension(AUC,0.693,P=0.080)or PHASES score(AUC,0.577,P=0.244)could not be used to predict the risk of rebleeding after admission.The calibration curve for the probability of rebleeding showed a good agreement between the prediction through clinical+morphological nomogram and actual observation.Conclusion:Hypertension,bifurcation site,and AR were independent risk factors related to the rebleeding of RIAs after admission.The clinical+morphological nomogram could help doctors to identify the high-risk RIAs with a high predictive accuracy.
