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Validation of the accuracy of the modified World Federation of Neurosurgical Societies subarachnoid hemorrhage grading scale for predicting the outcomes of patients with aneurysmal subarachnoid hemorrhage

Author

Listed:
  • Tuan Anh Nguyen
  • Ton Duy Mai
  • Luu Dang Vu
  • Co Xuan Dao
  • Hung Manh Ngo
  • Hai Bui Hoang
  • Tuan Anh Tran
  • Trang Quynh Pham
  • Dung Thi Pham
  • My Ha Nguyen
  • Linh Quoc Nguyen
  • Phuong Viet Dao
  • Duong Ngoc Nguyen
  • Hien Thi Thu Vuong
  • Hung Dinh Vu
  • Dong Duc Nguyen
  • Thanh Dang Vu
  • Dung Tien Nguyen
  • Anh Le Ngoc Do
  • Cuong Duy Nguyen
  • Son Ngoc Do
  • Hao The Nguyen
  • Chi Van Nguyen
  • Anh Dat Nguyen
  • Chinh Quoc Luong

Abstract

Background: Evaluating the prognosis of patients with aneurysmal subarachnoid hemorrhage (aSAH) who may be at risk of poor outcomes using grading systems is one way to make a better decision on treatment for these patients. This study aimed to compare the accuracy of the modified World Federation of Neurosurgical Societies (WFNS), WFNS, and Hunt and Hess (H&H) Grading Scales in predicting the outcomes of patients with aSAH. Methods: From August 2019 to June 2021, we conducted a multicenter prospective cohort study on adult patients with aSAH in three central hospitals in Hanoi, Vietnam. The primary outcome was the 90-day poor outcome, measured by a score of 4 (moderately severe disability) to 6 (death) on the modified Rankin Scale (mRS). We calculated the areas under the receiver operator characteristic (ROC) curve (AUROCs) to determine how well the grading scales could predict patient prognosis upon admission. We also used ROC curve analysis to find the best cut-off value for each scale. We compared AUROCs using Z-statistics and compared 90-day mean mRS scores among intergrades using the pairwise multiple-comparison test. Finally, we used logistic regression to identify factors associated with the 90-day poor outcome. Results: Of 415 patients, 32% had a 90-day poor outcome. The modified WFNS (AUROC: 0.839 [95% confidence interval, CI: 0.795–0.883]; cut-off value≥2.50; PAUROC

Suggested Citation

  • Tuan Anh Nguyen & Ton Duy Mai & Luu Dang Vu & Co Xuan Dao & Hung Manh Ngo & Hai Bui Hoang & Tuan Anh Tran & Trang Quynh Pham & Dung Thi Pham & My Ha Nguyen & Linh Quoc Nguyen & Phuong Viet Dao & Duong, 2023. "Validation of the accuracy of the modified World Federation of Neurosurgical Societies subarachnoid hemorrhage grading scale for predicting the outcomes of patients with aneurysmal subarachnoid hemorrhage," PLOS ONE, Public Library of Science, vol. 18(8), pages 1-23, August.
    • Handle: RePEc:plo:pone00:0289267
    DOI: 10.1371/journal.pone.0289267
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