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
PICI, AComm, MCA bifurcation, other MCA, proximal ICA
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.
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