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. 2023 Jun 16;23(1):232.
doi: 10.1186/s12883-023-03279-3.

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

Bambang Tri Prasetyo #  1   2 , Ricky Gusanto Kurniawan #  1   2 , Beny Rilianto #  3   4 , Pratiwi Raissa Windiani  1 , Kelvin Theandro Gotama  1 , Sardiana Salam  2   5 , Ita Muharram Sari  2   5 , Eka Musridharta  2   5 , Abrar Arham  1   2   6 , Muhammad Kusdiansah  2   6 , Lyna Soertidewi Kiemas  2   7 , Mursyid Bustami  2   5
Affiliations

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

Bambang Tri Prasetyo et al. BMC Neurol. .

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.

Keywords: Aneurysmal subarachnoid hemorrhage; Clinical score; Length of stay.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Subject flow diagram. LOS: length of stay
Fig. 2
Fig. 2
Logistic regression equation
Fig. 3
Fig. 3
Receiver Operating Characteristics (ROC) curve with sensitivity and specificity of scoring
Fig. 4
Fig. 4
Probability of prolonged length of stay for each total score
See this image and copyright information in PMC

References

    1. Chalouhi N, Hoh BL, Hasan D. Review of cerebral aneurysm formation, growth, and rupture. Stroke. 2013;44(12):3613–3622. doi: 10.1161/STROKEAHA.113.002390. - DOI - PubMed
    1. Nieuwkamp DJ, Setz LE, Algra A, Linn FH, de Rooij NK, Rinkel GJ. Changes in case fatality of aneurysmal subarachnoid haemorrhage over time, according to age, sex, and region: A meta-analysis. Lancet Neurol. 2009;8(7):635–642. doi: 10.1016/S1474-4422(09)70126-7. - DOI - PubMed
    1. de Rooij NK, Linn FH, van der Plas JA, Algra A, Rinkel GJ. Incidence of subarachnoid haemorrhage: A systematic review with emphasis on region, age, gender and time trends. J Neurol Neurosurg Psychiatry. 2007;78(12):1365–1372. doi: 10.1136/jnnp.2007.117655. - DOI - PMC - PubMed
    1. Chahyani W, Rinaldy MI, Hastuti MS, Wahyuni T. Mortality rate of spontaneous subarachnoid hemorrhage and related factors in pasar minggu regional general hospital. J Neurol Sci. 2019;405:70. doi: 10.1016/j.jns.2019.10.558. - DOI
    1. Diringer MN, Bleck TP, Claude Hemphill J 3rd, Menon D, Shutter L, Vespa P, et al. Critical care management of patients following aneurysmal subarachnoid hemorrhage: Recommendations from the neurocritical care society’s multidisciplinary consensus conference. Neurocrit Care. 2011;15(2):211–40. - PubMed