BMJ:颅内动脉瘤破裂患者蛛网膜下腔出血预后评估模型

2018-01-22 zhangfan MedSci原创

研究开发颅内动脉瘤破裂患者蛛网膜下腔出血预后影响因素评估模型,该方法表现出了极高的预测准确性,对于患者入院后治疗方法的选择具有一定的指导作用

近日研究人员开发并验证了颅内动脉瘤破裂患者(SAH) 蛛网膜下腔出血风险的预测模型。

模型建立所使用的颅内动脉瘤蛛网膜下腔出血(SAHIT)数据来自随机临床试验、前瞻性观察研究和医院登记。研究人员依据格拉斯哥结果评分预测了SAHIT患者3个月的死亡以及功能性预后结果。

10936名患者参与建模研究,3355人参与验证研究。模型核心因素包括患者年龄、术前血压和入院时神经学分级。模型核心因素对于患者功能性预后的预测具有极高的区分度,其AUC为0.80。在核心因素的基础上增加血栓体积、动脉瘤大小和位置因素等全模型因素后,AUC提高至0.81。全模型因素基础上增加治疗方法因素不能进一步提高AUC。全模型因素对患者死亡风险预测的AUC为0.76。所有模型在验证队列中均显示出满意的校准效果。

研究开发颅内动脉瘤破裂患者蛛网膜下腔出血预后影响因素评估模型,该方法表现出了极高的预测准确性,对于患者入院后治疗方法的选择具有一定的指导作用。

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    2018-02-17 gaoxiaoe
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  5. 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createdAvatar=, createdBy=60791943465, createdName=1e0f8808m18(暂无匿称), createdTime=Mon Jan 22 19:14:40 CST 2018, time=2018-01-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=280991, encodeId=18f028099199, content=近日研究人员开发并验证了颅内动脉瘤破裂患者(SAH)蛛网膜下腔出血风险的预测模型., beContent=null, objectType=article, channel=null, level=null, likeNumber=60, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo7cJ6ejWUr2nIia8qOvAKNdLHr32Df6G8iaoaOx6pHaoiacwp26DaslxZHCGbibZhhCGven4rvmWP60GahtzgFjgCjR/0, createdBy=6b111703011, createdName=有备才能无患, createdTime=Mon Jan 22 15:35:17 CST 2018, time=2018-01-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=280990, encodeId=7c33280990e7, content=近日研究人员开发并验证了颅内动脉瘤破裂患者(SAH)蛛网膜下腔出血风险的预测模型., beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo7cJ6ejWUr2nIia8qOvAKNdLHr32Df6G8iaoaOx6pHaoiacwp26DaslxZHCGbibZhhCGven4rvmWP60GahtzgFjgCjR/0, createdBy=6b111703011, createdName=有备才能无患, createdTime=Mon Jan 22 15:34:45 CST 2018, time=2018-01-22, status=1, ipAttribution=)]
    2018-01-29 巴黎夜雨

    很不错.内容丰富.

    0

  6. 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createdAvatar=, createdBy=60791943465, createdName=1e0f8808m18(暂无匿称), createdTime=Mon Jan 22 19:14:40 CST 2018, time=2018-01-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=280991, encodeId=18f028099199, content=近日研究人员开发并验证了颅内动脉瘤破裂患者(SAH)蛛网膜下腔出血风险的预测模型., beContent=null, objectType=article, channel=null, level=null, likeNumber=60, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo7cJ6ejWUr2nIia8qOvAKNdLHr32Df6G8iaoaOx6pHaoiacwp26DaslxZHCGbibZhhCGven4rvmWP60GahtzgFjgCjR/0, createdBy=6b111703011, createdName=有备才能无患, createdTime=Mon Jan 22 15:35:17 CST 2018, time=2018-01-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=280990, encodeId=7c33280990e7, content=近日研究人员开发并验证了颅内动脉瘤破裂患者(SAH)蛛网膜下腔出血风险的预测模型., beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo7cJ6ejWUr2nIia8qOvAKNdLHr32Df6G8iaoaOx6pHaoiacwp26DaslxZHCGbibZhhCGven4rvmWP60GahtzgFjgCjR/0, createdBy=6b111703011, createdName=有备才能无患, createdTime=Mon Jan 22 15:34:45 CST 2018, time=2018-01-22, status=1, ipAttribution=)]
    2018-01-24 巴黎夜雨

    谢谢分享.比较受用.

    0

  7. 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encryptionId=5ab788e81d3, topicName=蛛网膜)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=396c24497244, createdName=aliceclz, createdTime=Sat Dec 29 22:30:00 CST 2018, time=2018-12-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=283304, encodeId=8ae728330404, content=很不错.内容丰富., beContent=null, objectType=article, channel=null, level=null, likeNumber=47, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160804/IMG57A3418665C867262.jpg, createdBy=16b41925372, createdName=巴黎夜雨, createdTime=Mon Jan 29 22:06:57 CST 2018, time=2018-01-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=281704, encodeId=e8b3281e044f, content=谢谢分享.比较受用., beContent=null, objectType=article, channel=null, level=null, likeNumber=55, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160804/IMG57A3418665C867262.jpg, createdBy=16b41925372, createdName=巴黎夜雨, createdTime=Wed Jan 24 22:12:43 CST 2018, time=2018-01-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=281082, encodeId=6911281082d2, content=henhao, beContent=null, objectType=article, channel=null, level=null, likeNumber=48, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2018/01/14/98b313dfe26b90ecf72d9fa320a8b56b.jpg, createdBy=ca4a2247226, createdName=红木中餐, createdTime=Mon Jan 22 21:53:52 CST 2018, time=2018-01-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=281024, encodeId=d370281024b8, content=学习了.谢谢分享., beContent=null, objectType=article, channel=null, level=null, likeNumber=37, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=60791943465, createdName=1e0f8808m18(暂无匿称), createdTime=Mon Jan 22 19:14:40 CST 2018, time=2018-01-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=280991, encodeId=18f028099199, content=近日研究人员开发并验证了颅内动脉瘤破裂患者(SAH)蛛网膜下腔出血风险的预测模型., beContent=null, objectType=article, channel=null, level=null, likeNumber=60, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo7cJ6ejWUr2nIia8qOvAKNdLHr32Df6G8iaoaOx6pHaoiacwp26DaslxZHCGbibZhhCGven4rvmWP60GahtzgFjgCjR/0, createdBy=6b111703011, createdName=有备才能无患, createdTime=Mon Jan 22 15:35:17 CST 2018, time=2018-01-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=280990, encodeId=7c33280990e7, content=近日研究人员开发并验证了颅内动脉瘤破裂患者(SAH)蛛网膜下腔出血风险的预测模型., beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo7cJ6ejWUr2nIia8qOvAKNdLHr32Df6G8iaoaOx6pHaoiacwp26DaslxZHCGbibZhhCGven4rvmWP60GahtzgFjgCjR/0, createdBy=6b111703011, createdName=有备才能无患, createdTime=Mon Jan 22 15:34:45 CST 2018, time=2018-01-22, status=1, ipAttribution=)]
    2018-01-22 红木中餐

    henhao

    0

  8. 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createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160804/IMG57A3418665C867262.jpg, createdBy=16b41925372, createdName=巴黎夜雨, createdTime=Wed Jan 24 22:12:43 CST 2018, time=2018-01-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=281082, encodeId=6911281082d2, content=henhao, beContent=null, objectType=article, channel=null, level=null, likeNumber=48, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2018/01/14/98b313dfe26b90ecf72d9fa320a8b56b.jpg, createdBy=ca4a2247226, createdName=红木中餐, createdTime=Mon Jan 22 21:53:52 CST 2018, time=2018-01-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=281024, encodeId=d370281024b8, content=学习了.谢谢分享., beContent=null, objectType=article, channel=null, level=null, likeNumber=37, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=60791943465, createdName=1e0f8808m18(暂无匿称), createdTime=Mon Jan 22 19:14:40 CST 2018, time=2018-01-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=280991, encodeId=18f028099199, content=近日研究人员开发并验证了颅内动脉瘤破裂患者(SAH)蛛网膜下腔出血风险的预测模型., beContent=null, objectType=article, channel=null, level=null, likeNumber=60, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo7cJ6ejWUr2nIia8qOvAKNdLHr32Df6G8iaoaOx6pHaoiacwp26DaslxZHCGbibZhhCGven4rvmWP60GahtzgFjgCjR/0, createdBy=6b111703011, createdName=有备才能无患, createdTime=Mon Jan 22 15:35:17 CST 2018, time=2018-01-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=280990, encodeId=7c33280990e7, content=近日研究人员开发并验证了颅内动脉瘤破裂患者(SAH)蛛网膜下腔出血风险的预测模型., beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo7cJ6ejWUr2nIia8qOvAKNdLHr32Df6G8iaoaOx6pHaoiacwp26DaslxZHCGbibZhhCGven4rvmWP60GahtzgFjgCjR/0, createdBy=6b111703011, createdName=有备才能无患, createdTime=Mon Jan 22 15:34:45 CST 2018, time=2018-01-22, status=1, ipAttribution=)]
    2018-01-22 1e0f8808m18(暂无匿称)

    学习了.谢谢分享.

    0

  9. [GetPortalCommentsPageByObjectIdResponse(id=2053330, encodeId=864420533309f, content=<a href='/topic/show?id=a4c91003847b' target=_blank style='color:#2F92EE;'>#颅内动脉瘤破裂#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=35, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=100384, encryptionId=a4c91003847b, topicName=颅内动脉瘤破裂)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=640c454, createdName=qblt, createdTime=Fri Feb 02 06:30:00 CST 2018, time=2018-02-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1848440, encodeId=6de7184844082, content=<a href='/topic/show?id=2977356edc' target=_blank style='color:#2F92EE;'>#BMJ#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=3567, encryptionId=2977356edc, topicName=BMJ)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=148754, 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encryptionId=5ab788e81d3, topicName=蛛网膜)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=396c24497244, createdName=aliceclz, createdTime=Sat Dec 29 22:30:00 CST 2018, time=2018-12-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=283304, encodeId=8ae728330404, content=很不错.内容丰富., beContent=null, objectType=article, channel=null, level=null, likeNumber=47, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160804/IMG57A3418665C867262.jpg, createdBy=16b41925372, createdName=巴黎夜雨, createdTime=Mon Jan 29 22:06:57 CST 2018, time=2018-01-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=281704, encodeId=e8b3281e044f, content=谢谢分享.比较受用., beContent=null, objectType=article, channel=null, level=null, likeNumber=55, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160804/IMG57A3418665C867262.jpg, createdBy=16b41925372, createdName=巴黎夜雨, createdTime=Wed Jan 24 22:12:43 CST 2018, time=2018-01-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=281082, encodeId=6911281082d2, content=henhao, beContent=null, objectType=article, channel=null, level=null, likeNumber=48, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2018/01/14/98b313dfe26b90ecf72d9fa320a8b56b.jpg, createdBy=ca4a2247226, createdName=红木中餐, createdTime=Mon Jan 22 21:53:52 CST 2018, time=2018-01-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=281024, encodeId=d370281024b8, content=学习了.谢谢分享., beContent=null, objectType=article, channel=null, level=null, likeNumber=37, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=60791943465, createdName=1e0f8808m18(暂无匿称), createdTime=Mon Jan 22 19:14:40 CST 2018, time=2018-01-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=280991, encodeId=18f028099199, content=近日研究人员开发并验证了颅内动脉瘤破裂患者(SAH)蛛网膜下腔出血风险的预测模型., beContent=null, objectType=article, channel=null, level=null, likeNumber=60, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo7cJ6ejWUr2nIia8qOvAKNdLHr32Df6G8iaoaOx6pHaoiacwp26DaslxZHCGbibZhhCGven4rvmWP60GahtzgFjgCjR/0, createdBy=6b111703011, createdName=有备才能无患, createdTime=Mon Jan 22 15:35:17 CST 2018, time=2018-01-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=280990, encodeId=7c33280990e7, content=近日研究人员开发并验证了颅内动脉瘤破裂患者(SAH)蛛网膜下腔出血风险的预测模型., beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo7cJ6ejWUr2nIia8qOvAKNdLHr32Df6G8iaoaOx6pHaoiacwp26DaslxZHCGbibZhhCGven4rvmWP60GahtzgFjgCjR/0, createdBy=6b111703011, createdName=有备才能无患, createdTime=Mon Jan 22 15:34:45 CST 2018, time=2018-01-22, status=1, ipAttribution=)]
    2018-01-22 有备才能无患

    近日研究人员开发并验证了颅内动脉瘤破裂患者(SAH)蛛网膜下腔出血风险的预测模型.

    0

  10. 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createdAvatar=, createdBy=60791943465, createdName=1e0f8808m18(暂无匿称), createdTime=Mon Jan 22 19:14:40 CST 2018, time=2018-01-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=280991, encodeId=18f028099199, content=近日研究人员开发并验证了颅内动脉瘤破裂患者(SAH)蛛网膜下腔出血风险的预测模型., beContent=null, objectType=article, channel=null, level=null, likeNumber=60, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo7cJ6ejWUr2nIia8qOvAKNdLHr32Df6G8iaoaOx6pHaoiacwp26DaslxZHCGbibZhhCGven4rvmWP60GahtzgFjgCjR/0, createdBy=6b111703011, createdName=有备才能无患, createdTime=Mon Jan 22 15:35:17 CST 2018, time=2018-01-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=280990, encodeId=7c33280990e7, content=近日研究人员开发并验证了颅内动脉瘤破裂患者(SAH)蛛网膜下腔出血风险的预测模型., beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo7cJ6ejWUr2nIia8qOvAKNdLHr32Df6G8iaoaOx6pHaoiacwp26DaslxZHCGbibZhhCGven4rvmWP60GahtzgFjgCjR/0, createdBy=6b111703011, createdName=有备才能无患, createdTime=Mon Jan 22 15:34:45 CST 2018, time=2018-01-22, status=1, ipAttribution=)]
    2018-01-22 有备才能无患

    近日研究人员开发并验证了颅内动脉瘤破裂患者(SAH)蛛网膜下腔出血风险的预测模型.

    0

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由此可见,使用降糖药物而不是高血糖与动脉瘤性蛛网膜下腔出血的风险降低相关,提示降糖药物在动脉瘤破裂发病机制中可能发挥保护性作用。