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Changes in Outcome Prediction During the First Week After Subarachnoid Hemorrhage 蛛网膜下腔出血后第一周预后预测的变化
Pub Date : 2022-10-21 DOI: 10.1227/neuopn.0000000000000021
James Booker, Peter Barron, Laura Newitt, Simran Chhugani, Awais Sarwar, F. Ewbank, B. Gaastra, D. Bulters
Prediction of long-term outcome based on initial neurological condition after aneurysmal subarachnoid hemorrhage varies with time. To date, studies have been limited to early time points and have reported that prognostication is best after resuscitation. To describe how prediction of outcome varies from ictus through the first week of admission. A retrospective analysis of patients with a diagnosis of aneurysmal subarachnoid hemorrhage recruited to a prospective database. Neurological condition was recorded on each day of the inpatient stay, up to day 7, using World Federation of Neurological Societies score (WFNS). Poor outcome was defined by modified Rankin scale of 3-6 at 3 months. Outcome prediction was assessed using area under the curve (AUC) after binary logistic regression. Of 645 patients, 55(14%) patients with WFNS 1&2 and 77(45%) patients with WFNS 4&5 on day 0 had a poor outcome. 30(8%) patients with WFNS 1&2 and 54(81%) patients with WFNS 4&5 on day 7 had a poor outcome. Prognostication using WFNS improved from day 0 to day 7 (AUC = 70.1%, CI 65.0%–75.1% vs AUC = 81.9%, CI 77.4%–86.0%) with an incremental improvement with each day in between, and the largest increases early around the time of resuscitation. Prediction of outcome improves beyond the initial resuscitation, up to day 7 of admission, with no evidence of any deterioration around the time of treatment or delayed complications like delayed cerebral ischemia. This is important when prognosticating for clinical purposes and emphasizes the importance of standardization of timing of WFNS in research.
根据动脉瘤性蛛网膜下腔出血后的初始神经状况预测长期结果随时间变化。到目前为止,研究仅限于早期时间点,并报告复苏后的预后最好。描述从发作到入院第一周对结果的预测是如何变化的。前瞻性数据库中招募的诊断为动脉瘤性蛛网膜下腔出血的患者的回顾性分析。使用世界神经学会联合会评分(WFNS)记录住院期间的每一天,直到第7天。3个月时,通过改良的Rankin量表3-6定义不良结果。使用二元逻辑回归后的曲线下面积(AUC)评估结果预测。在645名患者中,第0天,55名(14%)WFNS 1和2患者和77名(45%)WFNS 4和5患者的结果较差。第7天,30名(8%)WFNS 1和2患者和54名(81%)WFNS 4和5患者的结果较差。从第0天到第7天,使用WFNS的预后得到改善(AUC=70.1%,CI 65.0%-75.1%vs AUC=81.9%,CI 77.4%-86.0%),在这期间的每一天都有逐渐改善,复苏早期的增加幅度最大。在最初的复苏之后,直到入院第7天,结果的预测都有所改善,没有证据表明治疗期间有任何恶化或延迟性并发症,如延迟性脑缺血。这在为临床目的进行预测时很重要,并强调了WFNS在研究中时间标准化的重要性。
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引用次数: 0
Geniculate Neuralgia: A Case Report and Systematic Review 生殖器神经痛1例报告及系统评价
Pub Date : 2022-10-14 DOI: 10.1227/neuopn.0000000000000022
R. Tatit, Paulo Eduardo Albuquerque Zito Raffa, M. Seba, P. Franceschini, P. H. D. de Aguiar
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引用次数: 0
Characteristic of Non–Sinus-Type Parasagittal Dural Arteriovenous Fistulas: Clinical and Cadaveric Experiences 非窦型矢状旁硬脑膜动静脉瘘的特点:临床和尸体经验
Pub Date : 2022-10-04 DOI: 10.1227/neuopn.0000000000000019
S. Miyake, Y. Nakai, J. Suenaga, Taisuke Akimoto, K. Uemura, K. Funakoshi, Tetsuya Yamamoto
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引用次数: 0
Acute Development of a Traumatic Pseudoaneurysm of the Posterior Inferior Cerebellar Artery Due to a Fracture of the Clivus 斜坡骨折致小脑后下动脉创伤性假性动脉瘤的急性发展
Pub Date : 2022-10-04 DOI: 10.1227/neuopn.0000000000000018
S. Nishihiro, T. Ichikawa, Yu Takahashi, Yuta Tsuyuguchi, Yuichi Hirata, Satoshi Kuramoto, Yasuhiro Ono, Y. Goda, M. Kawauchi
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引用次数: 0
Utilization of Navigation-Integrated, Mixed Reality Templates for Minimizing Invasiveness of Neurosurgical Procedures: A Case Series 利用导航集成、混合现实模板最大限度地减少神经外科手术的侵袭性:一个案例系列
Pub Date : 2022-09-20 DOI: 10.1227/neuopn.0000000000000017
W. Jean, Kenneth Sack
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引用次数: 1
Trial Registry Use in Neurosurgery Systematic Reviews With Meta-Analyses: A Cross-Sectional Analysis 神经外科meta分析系统评价中试验注册表的使用:一项横断面分析
Pub Date : 2022-09-19 DOI: 10.1227/neuopn.0000000000000015
Blake Bertolino, S. Rivera, Brenda Perez, Arjun K. Reddy, M. Vassar
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引用次数: 0
Comparative Effectiveness of Management by Surgical Resection vs Observation for Cerebral Cavernous Malformations: A Matched Propensity Score Analysis 脑海绵状血管瘤手术切除与观察治疗的比较效果:匹配倾向评分分析
Pub Date : 2022-08-10 DOI: 10.1227/neuopn.0000000000000011
Rowland H. Han, G. Johnson, Andrew T. Coxon, Vivek P. Gupta, Matthew J. Richards, S. Lancia, A. Salter, M. Miller-Thomas, R. Dacey, G. Zipfel, Joshua W. Osbun
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引用次数: 0
Idiopathic Spinal Subarachnoid and Subdural Hemorrhage in a Patient With Eosinophilic Granulomatosis and Polyangiitis 嗜酸性粒细胞增多症和多血管炎患者的特发性蛛网膜下腔和硬膜下出血
Pub Date : 2022-07-14 DOI: 10.1227/neuopn.0000000000000014
William J Smith, J. Kanter, Naser Jaleel, J. Aronson
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引用次数: 0
Pseudoaneurysm of Distal Anterior Cerebral Artery Secondary to External Ventricular Drain: A Case Report and Review of the Literature 继发于脑室外引流的大脑前动脉远端假性动脉瘤1例报告及文献复习
Pub Date : 2022-06-09 DOI: 10.1227/neuopn.0000000000000009
Breanne Reisen, Nickolas Kinachtchouk, Michael L. Hudson, Joseph G. Adel
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引用次数: 0
Representation of Women as Neurological Surgery Society Award Recipients 女性作为神经外科学会获奖者的代表性
Pub Date : 2022-05-10 DOI: 10.1227/neuopn.0000000000000008
G. Johnson, Alison Almgren-Bell, Alex Skidmore, Dhvani Raval, Gretchen Blow, Kimberly a. Mackey, M. Groves, Hedwig Lee, J. Strahle
{"title":"Representation of Women as Neurological Surgery Society Award Recipients","authors":"G. Johnson, Alison Almgren-Bell, Alex Skidmore, Dhvani Raval, Gretchen Blow, Kimberly a. Mackey, M. Groves, Hedwig Lee, J. Strahle","doi":"10.1227/neuopn.0000000000000008","DOIUrl":"https://doi.org/10.1227/neuopn.0000000000000008","url":null,"abstract":"","PeriodicalId":93342,"journal":{"name":"Neurosurgery open","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47496238","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 1
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