The GAHR score for prediction of in-hospital mortality patients with aneurysmal subarachnoid hemorrhage

Abstract

Background: Aneurysmal subarachnoid hemorrhage (aSAH) remains a prominent cause of mortality. There are several factors associated with the overall outcome. This study aimed to develop a simple scoring model of the 30-day mortality in aSAH.

Methods: We retrospectively analyzed the total number of aSAH patients hospitalized at the advanced stroke center between January 2019 and June 2022. Multivariable logistic regression generated the odds ratio of age- and sex-adjusted mortality for aSAH. Scoring predictors were derived from regression β-coefficients and converted into a point score system. The diagnostic performance and probability of in-hospital mortality were assessed.

Results: We included 318 aSAH patients, and 61 (19.18%) patients died during hospitalization. The aSAH mortality prediction (GAHR) score with a range of 0-12 points was assigned the following point values: grade of aSAH (4 points), aneurysmal treatment (3 points), heart comorbidities (2 points), and respiratory failure (3 points). The GAHR score displayed an area under the receiving operating characteristics curve (AUC) of 0.8294 (SE 0.0277) and a p-value for the Hosmer-Lemeshow (HL) goodness-of-fit of 0.4133. The probability of in-hospital mortality was assessed based on the total score of each patient.

Conclusions: The GAHR score is a simple, convenient, and reliable scoring system with four clinical predictors containing grade, aneurysmal treatment, heart comorbidities, and respiratory failure to predict in-hospital mortality of aSAH. This scoring system has good accuracy and may aid clinicians in decision-making and determining the prognosis of patients.

Keywords: Aneurysmal subarachnoid hemorrhage; Clipping; Coiling; In-hospital mortality; Prediction; Scoring.