Dataset Information

Clinical prediction score for prolonged length of hospital stay in aneurysmal subarachnoid hemorrhage.

ABSTRACT:

Background

Length of stay (LOS) is an important indicator of the optimization of health services and hospital financing efficiency in aneurysmal subarachnoid hemorrhage (aSAH) patients. The purpose of this study was to develop a scoring model to predict the LOS of patients with aSAH.

Method

A clinical scoring was developed based on retrospectively collected data from the cerebral aneurysm registry of the National Brain Center Hospital, Jakarta, from January 2019 to June 2022. Multivariate logistic regression was used to determine the odds ratio for risk-adjusted prolonged LOS. LOS predictors were obtained based on the regression coefficients and converted into a point score model.

Results

Of the 209 aSAH patients observed, 117 patients had prolonged LOS (> 14 days of hospital stay). A clinical score was developed with a range of 0-7 points. Four variables were chosen as predictors of prolonged LOS: the presence of high-grade aSAH (1 point), aneurysm treatment (endovascular coiling: 1 point; surgical clipping: 2 points), cardiovascular comorbidities (1 point), and hospital-acquired pneumonia (3 points). The score showed good discrimination with an area under the receiving operating characteristics curve (AUC) of 0.8183 (SE 0.0278) and a p-value for the Hosmer-Lemeshow (HL) goodness-of-fit of 0.9322.

Conclusion

This simple clinical score reliably predicted prolonged LOS in aneurysmal subarachnoid hemorrhage cases and may aid clinicians in improving patient outcomes and decreasing healthcare costs.

SUBMITTER: Prasetyo BT

PROVIDER: S-EPMC10273541 | biostudies-literature | 2023 Jun

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Clinical prediction score for prolonged length of hospital stay in aneurysmal subarachnoid hemorrhage.

Prasetyo Bambang Tri BT Kurniawan Ricky Gusanto RG Rilianto Beny B Windiani Pratiwi Raissa PR Gotama Kelvin Theandro KT Salam Sardiana S Sari Ita Muharram IM Musridharta Eka E Arham Abrar A Kusdiansah Muhammad M Kiemas Lyna Soertidewi LS Bustami Mursyid M

BMC neurology 20230616 1

<h4>Background</h4>Length of stay (LOS) is an important indicator of the optimization of health services and hospital financing efficiency in aneurysmal subarachnoid hemorrhage (aSAH) patients. The purpose of this study was to develop a scoring model to predict the LOS of patients with aSAH.<h4>Method</h4>A clinical scoring was developed based on retrospectively collected data from the cerebral aneurysm registry of the National Brain Center Hospital, Jakarta, from January 2019 to June 2022. Mult ...[more]

PMID: 37328746

Similar Datasets

Project description:BackgroundDespite intensive research on preventing and treating vasospasm and delayed cerebral ischemia in aneurysmal subarachnoid hemorrhage (aSAH), mortality and morbidity rates remain high. Early brain injury (EBI) has emerged as possibly the major significant factor in aSAH pathophysiology, emphasizing the need to investigate EBI-associated clinical events for improved patient management and decision-making. This study aimed to identify early clinical and radiological events within 72 h after aSAH to develop a conclusive predictive EBI score for clinical practice.MethodsThis retrospective analysis included 561 consecutive patients with aSAH admitted to our neurovascular center between 01/2014 and 09/2022. Fourteen potential predictors occurring within the initial 72 h after hemorrhage were analyzed. The modified Rankin Scale (mRS) score at 6 months, discretized to three levels (0-2, favorable; 3-5, poor; 6, dead), was used as the outcome variable. Univariate ordinal regression ranked predictors by significance, and forward selection with McFadden's pseudo-R2 determined the optimal set of predictors for multivariate proportional odds logistic regression. Collinear parameters were excluded, and fivefold cross-validation was used to avoid overfitting.ResultsThe analysis resulted in the Subarachnoid Hemorrhage Associated Early Brain Injury Outcome Prediction score (SHELTER-score), comprising seven clinical and radiological events: age (0-4 points), World Federation of Neurosurgical Societies (0-2.5 points), cardiopulmonary resuscitation (CPR) (2 points), mydriasis (1-2 points), midline shift (0.5-1 points), early deterioration (1 point), and early ischemic lesion (2 points). McFadden's pseudo-R2 = 0.339, area under the curve for death or disability 0.899 and 0.877 for death. A SHELTER-score below 5 indicated a favorable outcome (mRS 0-2), 5-6.5 predicted a poor outcome (mRS 3-5), and ≥ 7 correlated with death (mRS 6) at 6 months.ConclusionsThe novel SHELTER-score, incorporating seven clinical and radiological features of EBI, demonstrated strong predictive performance in determining clinical outcomes. This scoring system serves as a valuable tool for neurointensivists to identify patients with poor outcomes and guide treatment decisions, reflecting the great impact of EBI on the overall outcome of patients with aSAH.

Project description:BackgroundThe epidemic of Coronavirus Disease 2019 (COVID-19) has become a global health emergency, but the clinical characteristics of COVID-19 are not fully described. We aimed to describe the clinical characteristics of COVID-19 outside of Wuhan city; and to develop a multivariate model to predict the risk of prolonged length of stay in hospital (ProLOS).MethodsThe study was conducted in a tertiary care hospital in Zhejiang province from January to February 20, 2020. Medical records of all confirmed cases of COVID-19 were retrospectively reviewed. Patients were categorized into the ProLOS and non-ProLOS groups by hospital length of stay greater and less than 14 days, respectively. Conventional descriptive statistics were applied. Multivariate regression model was built to predict the risk of ProLOS, with variables selected using stepwise approach.ResultsA total of 75 patients with confirmed COVID-19 were included for quantitative analysis, including 25 (33%) patients in the ProLOS group. ProLOS patients were more likely to have history of traveling to Wuhan (68% vs. 28%; P=0.002). Patients in the ProLOS group showed lower neutrophil counts [median (IQR): 2.50 (1.77-3.23) ×109/L vs. 2.90 (2.21-4.19) ×109/L; P=0.048], higher partial thrombin time (PT) (13.42±0.63 vs. 13.10±0.48 s; P=0.029), lower D-Dimer [0.26 (0.22-0.46) vs. 0.44 (0.32-0.84) mg/L; P=0.012]. There was no patient died and no severe case in our cohort. The overall LOS was 11 days (IQR, 5-15 days). The median cost for a hospital stay was 7,388.19 RMB (IQR, 5,085.39-11,145.44). The prediction model included five variables of procalcitonin, heart rate, epidemiological history, lymphocyte count and cough. The discrimination of the model was 84.8% (95% CI: 75.3% to 94.4%).ConclusionsOur study described clinical characteristics of COVID-19 outside of Wuhan city and found that the illness was less severe than that in the core epidemic region. A multivariate model was developed to predict ProLOS, which showed good discrimination.

Dataset Information

Clinical prediction score for prolonged length of hospital stay in aneurysmal subarachnoid hemorrhage.

Background

Method

Results

Conclusion

Publications

Clinical prediction score for prolonged length of hospital stay in aneurysmal subarachnoid hemorrhage.

Similar Datasets

OmicsDI is part of the ELIXIR infrastructure

Tweets