Graeb score predicts the outcome of high-grade aneurysmal subarachnoid hemorrhage patients with intraventricular hemorrhage
10.3760/cma.j.issn.1673-4165.2021.07.006
- VernacularTitle:Graeb评分预测伴脑室出血的高分级动脉瘤性蛛网膜下腔出血患者转归
- Author:
Guofeng ZHANG
1
;
Rui LIANG
;
Hui LIU
;
Xinyong ZHANG
;
Zhi CAO
;
Weibing LIU
;
Youjia TANG
Author Information
1. 九江市第一人民医院神经外科 332001
- Keywords:
Intracranial aneurysm;
Subarachnoid hemorrhage;
Severity of illness index;
Cerebral hemorrhage;
Cerebral ventricles;
Treatment outcome;
Risk factors
- From:
International Journal of Cerebrovascular Diseases
2021;29(7):507-513
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the predictive value of Graeb score for the outcome of high-grade aneurysmal subarachnoid hemorrhage (aSAH) patients with intraventricular hemorrhage (IVH).Methods:Consecutive high-grade aSAH patients with IVH admitted to the No. 1 People's Hospital of Jiujiang from January 2012 to March 2020 were enrolled retrospectively. High-grade aSAH was defined as grade Ⅳ to Ⅴ according to the World Federation of Neurological Surgeons (WFNS) scale. The outcome of patients was evaluated by the modified Rankin Scale (mRS) at 3 months after discharge. A score of ≤2 was defined as a good outcome and a score of >2 were defined as a poor outcome. Multivariate logistic regression model was used to evaluate the correlation between Graeb score and clinical outcome, and the receiver operating characteristic (ROC) curve was used to determine the predictive value of Graeb score for clinical outcome. Results:A total of 86 high-grade aSAH patients with IVH were enrolled. Aneurysm treatment: craniotomy clipping in 42 patients (48.8%), intravascular embolization in 21 (24.4%), and conservative treatment in 23 (26.7%). Twenty-nine patients (33.7%) had a good outcome and 57 (66.3%) had a poor outcome. Multivariate logistic regression analysis showed that the Graeb score >6 (odds ratio [ OR] 26.360, 95% confidence interval [ CI] 4.106-169.235; P<0.001), the modified Fisher grade 3-4 ( OR 11.674, 95% CI 1.540-88.512; P=0.017) and complicated with chronic hydrocephalus ( OR 21.236, 95% CI 2.883-156.431; P=0.003) were the independent risk factors for the poor outcome. ROC curve analysis showed that the area under the curve of the Graeb score predicting for poor outcome was 0.843 (95% CI 0.760-0.926; P<0.001), the best cut-off value was 6.5, and the corresponding sensitivity and specificity were 71.9% and 86.2%, respectively. Conclusion:The Graeb score is an independent influencing factor affecting the clinical outcome of high-grade aSAH patients with IVH. Graeb score >6.5 had higher predictive value for the poor outcome in such patients.
