Comparison of prediction for short-term and long-term outcomes in patients with aneurysmal subarachnoid hemorrhage: a systematic review and meta-analysis.

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Tác giả: Haiqing Diao, Yuping Li, Xiaoguang Liu, Guangyu Lu, Qiang Ma, Chunxiang Yan, Lin Yang, Hailong Yu, Yang Zhang

Ngôn ngữ: eng

Ký hiệu phân loại: 920.71 Men

Thông tin xuất bản: Germany : Neurosurgical review , 2025

Mô tả vật lý:

Bộ sưu tập: NCBI

ID: 5178

 Despite extensive research on prediction models for outcomes in aneurysmal subarachnoid hemorrhage (aSAH) patients, the distinction between models for short- and long-term outcomes remains insufficiently explored. This study aims to compare these models, identify the risk factors of poor outcomes, summarize the predictors of outcomes, and assess the performance of the prediction models for short- and long-term outcomes in aSAH patients. PubMed, Web of Science, the Cochrane Library, and Embase were searched to identify studies investigating risk factors for developed and/or validated prediction models for short-term (<
  12 months) and long-term (≥ 12 months) outcomes in aSAH patients. The main outcome was neurological function, defined as poor if the Glasgow Outcome Scale (GOS) score was ≤ 3, or if the modified Rankin Scale (mRS) score was ≥ 3. Fifty-six studies reporting 61 models with 36,879 aSAH patients were included. A total of 93 predictors were examined and categorized into six domains including demographic factors, scoring systems, clinical factors, aneurysm characteristics, laboratory examinations, and imaging features. Among these, laboratory examinations were included in 57.45% (27/47) of models predicting short-term outcomes, while only 14.29% (2/14) of long-term prediction models incorporated them. An mFisher score of 3-4 [OR = 1.95, 95%CI (1.43, 2.64), P <
  0.01] and the presence of multiple aneurysms [OR = 1.56, 95% CI (1.25, 1.94), P <
  0.01] were identified as risk factors for poor short-term outcomes, however, this association was weakened in predicting poor long-term outcomes. All studies were found to have a high risk of bias, primarily due to inappropriate data sources and inadequate reporting of the analysis domain. This review suggested that aSAH patients with poor clinical scores and hypertension are at a higher risk of poor outcomes. The majority of the included prediction models perform well, but generally lack reporting in the analysis domain, which may hinder their clinical applicability.
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