Ban et al reported the Southwestern Aneurysm Severity Index (SASI) for evaluating patients with a ruptured intracranial hemorrhage. The authors are from the University of Texas Southwestern Medical Center in Dallas.
Patient selection: ruptured intracranial aneurysm with subarachnoid hemorrhage
Outcome: Glasgow Outcome Scale (GOS) at 12 months (favorable GOS 4 or 5)
Parameters:
(1) Hunt-Huss scale
(2) ASA class
(3) CT/MRI findings (intracerebral hemorrhage, hydrocephalus, intraventricular hemorrhage)
(4) aneurysm location
(5) age in years
(6) diameter of aneurysm
Parameter |
Finding |
Points |
Hunt Hess scale |
I |
1 |
|
II |
2 |
|
III |
3 |
|
IV |
4 |
|
V |
5 |
ASA class |
ASA 1 |
1 |
|
ASA 2 |
2 |
|
ASA 3 |
3 |
|
ASA 4 |
4 |
|
ASA 5 |
5 |
ICH on CT/MRI |
ICH< 30 mm |
2 |
|
ICH >= 30 mm |
8 |
hydrocephalus on CT/MRI |
no |
0 |
|
yes |
3 |
intraventricular hemorrhage |
no |
0 |
|
yes |
3 |
aneurysm location |
choroidal, ICA bifurcation, distal ACA, PC communicating |
0 |
|
1 |
|
|
basilar apex, basilar P1/P2, basilar trunk, SA, vertebral confluence, vertebral dissection |
5 |
age |
<= 64 years |
0 |
|
> 64 years |
5 |
diameter of aneurysm |
>= 20 mm (giant) |
7 |
|
< 20 mm |
0 |
where:
• The maximum score is given as 41. The table above arranged to achieve this.
total score =
= SUM(points for all of the parameters)
Interpretation:
• minimum score: 2
• maximum score: 41
Score |
Favorable GOS at 12 Months |
2 to 5 |
96% |
6 to 10 |
87% |
11 to 15 |
75% |
16 to 20 |
36% |
21 to 25 |
21% |
26 to 30 |
25% |
31 to 35 |
0% |
36 to 41 |
NA (0%) |
Performance:
• The area under the ROC curve is 0.82.
Specialty: Neurology