caa a22 4500 606214607 CHVBK 20210128101054.0 cr unu---uuuuu 210128e20151201xx s 000 0 eng 10.1007/s00701-015-2605-3 doi (NATIONALLICENCE)springer-10.1007/s00701-015-2605-3 The simplified acute physiology score II to predict hospital mortality in aneurysmal subarachnoid hemorrhage [Elektronische Daten] [Patrick Czorlich, Thomas Sauvigny, Franz Ricklefs, Stefan Kluge, Eik Vettorazzi, Jan Regelsberger, Manfred Westphal, Nils Schmidt] Background: Early prediction of increased morbidity and mortality in aneurysmal subarachnoid hemorrhage (aSAH) remains crucial to improving patient management. Most prediction models lack external validation and focus on disease-specific items without considering physiological parameters and the past medical history. The aim was to assess the validity of the established Simplified Acute Physiology Score II (SAPS-II) in an aSAH cohort for the prediction of hospital mortality and to identify additional physiological and clinical predictors. Methods: The predictive value of SAPS-II for hospital mortality was assessed in a retrospective analysis of 263 consecutive patients with aSAH. Additional physiological and clinical parameters including the past medical history were analyzed by forward selection multivariate analysis to identify independent predictors of hospital mortality and to improve the prediction model. Results: The SAPS-II predicted hospital mortality with an area under the curve (AUC) of 0.834 with an odds ratio (OR) of 1.097 [95 % confidence interval 1.067-1.128) for each additional point. Forward selection multivariate analysis identified the Glasgow Coma Scale score (P < 0.001), history of chronic headache (P = 0.01) and medication with anticoagulants (P = 0.04) as independent predictors of hospital mortality. Adding these parameters to the SAPS-II, the AUC increased to 0.86. Conclusion: This study validates the predictive accuracy of SAPS-II for hospital mortality in aSAH patients. Additional parameters from the past medical history increase its predictive power. From a practical viewpoint, SAPS-II alone already represents a sufficient and powerful score to predict hospital mortality at an early time point and may help to improve patient management. Springer-Verlag Wien, 2015 SAPS-II nationallicence Subarachnoid hemorrhage nationallicence Hospital mortality nationallicence Prediction models nationallicence Cerebral aneurysm nationallicence Czorlich Patrick Department of Neurosurgery, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany aut Sauvigny Thomas Department of Neurosurgery, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany aut Ricklefs Franz Department of Neurosurgery, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany aut Kluge Stefan Department of Intensive Care, University Medical Center Hamburg-Eppendorf, Hamburg, Germany aut Vettorazzi Eik Department of Medical Biometry and Epidemiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany aut Regelsberger Jan Department of Neurosurgery, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany aut Westphal Manfred Department of Neurosurgery, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany aut Schmidt Nils Department of Neurosurgery, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany aut Acta Neurochirurgica Springer Vienna 157/12(2015-12-01), 2051-2059 0001-6268 157:12<2051 2015 157 701 https://doi.org/10.1007/s00701-015-2605-3 text/html Onlinezugriff via DOI BK010053 XK010053 XK010000 Metadata rights reserved Springer special CC-BY-NC licence nationallicence 1 research-article jats NATIONALLICENCE NATIONALLICENCE NL-springer NATIONALLICENCE 856 40 https://doi.org/10.1007/s00701-015-2605-3 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Czorlich Patrick Department of Neurosurgery, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany aut NATIONALLICENCE 700 1- Sauvigny Thomas Department of Neurosurgery, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany aut NATIONALLICENCE 700 1- Ricklefs Franz Department of Neurosurgery, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany aut NATIONALLICENCE 700 1- Kluge Stefan Department of Intensive Care, University Medical Center Hamburg-Eppendorf, Hamburg, Germany aut NATIONALLICENCE 700 1- Vettorazzi Eik Department of Medical Biometry and Epidemiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany aut NATIONALLICENCE 700 1- Regelsberger Jan Department of Neurosurgery, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany aut NATIONALLICENCE 700 1- Westphal Manfred Department of Neurosurgery, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany aut NATIONALLICENCE 700 1- Schmidt Nils Department of Neurosurgery, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany aut NATIONALLICENCE 773 0- Acta Neurochirurgica Springer Vienna 157/12(2015-12-01), 2051-2059 0001-6268 157:12<2051 2015 157 701