Patient selection: aneurysm coiling following subarachnoid hemorrhage
Outcome: mortality at 1-year
Parameters:
(1) Glasgow coma score (GCS) on admission
(2) serum troponin I on admission in µg/L (Stratus, Dade)
(3) serum S100-beta in µg/L (Byk-Sangtec France Laboratories)
|
Parameter
|
Finding
|
Points
|
|
Glasgow coma score
|
15
|
0
|
|
|
14
|
1
|
|
|
13
|
2
|
|
|
3 to 12
|
3
|
|
serum troponin I
|
low (<= 0.5 µg/L)
|
0
|
|
|
high (> 0.5 µg/L)
|
1
|
|
serum S100-beta
|
low (<= 0.5 µg/L)
|
0
|
|
|
high (> 0.5 µg/L)
|
2
|
where:
• The cutoff for troponin I and S100-beta correspond to 5 times the upper limit of normal (ULN).
total score =
= SUM(points for all 3 parameters)
Interpretation:
• minimum score: 0
• maximum score: 6
• The higher the score the worse the prognosis.
Performance:
• The area under the ROC curve was 0.82 in the derivation set and 0.76 in the validation set.
• A score >= 2 had the same Youden index as a score >= 3.
• A score >= 2 had a sensitivity of 86% and specificity of 65%, with expected 1-year mortality >= 15%.
• A score >= 3 had a sensitivity of 73% and specificity of 78%, with expected 1-year mortality >= 25%.
