Prognostic Model for Chronic Shunt-Dependent Hydrocephalus After Aneurysmal Subarachnoid Hemorrhage.

摘要: Background Patients with aneurysmal subarachnoid hemorrhage (aSAH) are at risk of the development chronic shunt-dependent hydrocephalus. However, identification patients remains challenging. We sought to develop a prognostic model identify aSAH In addition well-known variables, blood clearance in cerebrospinal fluid (CSF) spaces was considered. Methods retrospectively analyzed data from 227 treated our institution January 2012 2016. The outcome ventriculoperitoneal shunt placement within 30 days after aSAH. candidate variables were patient age, World Federation Neurological Surgeons grade and Fisher grade, external ventricular drainage, intracerebral hemorrhage, interval peripheral/basal CSF spaces. Adjustment for multiple testing performed. Multivariable logistic regression analysis used development. Bootstrapping applied internal validation. performance measures included indexes explained variance (R2), calibration (graphic plot, Hosmer-Lemeshow test), discrimination (c-statistic). Results Of patients, 90 (39.6%) required shunt. constructed combined drainage placement, presence blood, duration basal cisterns. promising, an R2 33% (20% bootstrapping), plot adequate, test result not significant, c-statistic 0.85 (0.84 as assessed bootstrapping) indicating good discriminating model. Conclusions Our could help requiring permanent diversion aSAH, although additional modification validation needed. Interventions aimed accelerating cisterns might have potential prevent hydrocephalus