改良希吉德拉评分在动脉瘤性蛛网膜下腔出血患者中的价值。
The value of modified hijdra score in patients with aneurysmal subarachnoid hemorrhage.
作者信息
Wu Rongjie, Hu Fangbo, Liu Changtao, Liang Jingshan
机构信息
The Affiliated Lianyungang Hospital of Xuzhou Medical University/The Affiliated Hospital of Kangda College of Nanjing Medical University/Lianyungang Clinical College of Nanjing Medical University/The First People's Hospital of Lianyungang, Jiangsu, China.
Jinzhou Medical University, Liaoning, China.
出版信息
Heliyon. 2024 Mar 26;10(7):e28550. doi: 10.1016/j.heliyon.2024.e28550. eCollection 2024 Apr 15.
BACKGROUND
The complexity of calculating the Hijdra score has limited its clinical utility in aiding the diagnosis of intracranial ruptured aneurysms.
OBJECTIVE
This study aimed to investigate the diagnostic and prognostic value of the modified Hijdra score in patients with aneurysmal subarachnoid hemorrhage (aSAH).
METHODS
Data from 773 patients with subarachnoid hemorrhage (SAH) at the First People's Hospital of Lianyungang from January 2018 to June 2023 were collected. The modified Hijdra scoring method simplifies the assessment of 10 basal cisterns/cisterns fissures compared to the traditional scoring method, with scores ranging from 0 to 2 for each item, and assigns specific scores to hematomas larger than 1 cm in diameter. The data were divided into an evaluation group (n = 641) and a validation group (n = 132). In the evaluation group, the performance of the modified Hijdra score in diagnosis and prognostic prediction was assessed, while the diagnostic and prognostic prediction efficacy of the modified Hijdra method was evaluated using the validation set.
RESULTS
Among the 641 patients in the evaluation group,550 (85. 8%) were diagnosed with intracranial aneurysms. The modified Hijdra score demonstrated an AUC of 0. 894 for aneurysm diagnosis, with a sensitivity of 98. 0% and a specificity of 64. 8% at a CutOff value of 7. 5. The diagnostic efficacy of the modified Hijdra score was 93. 24%, with a negative predictive value of 84. 29%, while the Hijdra score 's diagnostic efficacy was 85. 34% with a negative predictive value of 48. 89%. The AUC of the modified Hijdra score for predicting prognosis in patients with aneurysms was 0. 824, with a sensitivity of 84. 3% and a specificity of 70. 0% at a CutOff value of 16. 5. In CTA-negative patients, the modified Hijdra score was significantly higher (P < 0. 0001) in patients with aneurysmal SAH (15. 48 ± 3. 93) compared to those with non-aneurysmal SAH (6. 31 ± 4. 52).
CONCLUSIONS
The modified Hijdra score is a valuable tool for assisting in the diagnosis and prognosis prediction of aneurysmal subarachnoid hemorrhage.
背景
计算Hijdra评分的复杂性限制了其在辅助诊断颅内破裂动脉瘤方面的临床应用。
目的
本研究旨在探讨改良Hijdra评分在动脉瘤性蛛网膜下腔出血（aSAH）患者中的诊断和预后价值。
方法
收集2018年1月至2023年6月连云港市第一人民医院773例蛛网膜下腔出血（SAH）患者的数据。与传统评分方法相比，改良Hijdra评分方法简化了对10个基底池/池裂的评估，每个项目的评分范围为0至2，并对直径大于1 cm的血肿赋予特定分数。将数据分为评估组（n = 641）和验证组（n = 132）。在评估组中，评估改良Hijdra评分在诊断和预后预测方面的性能，而使用验证集评估改良Hijdra方法的诊断和预后预测效能。
结果
在评估组的641例患者中，550例（85.8%）被诊断为颅内动脉瘤。改良Hijdra评分在动脉瘤诊断中的AUC为0.894，在临界值为7.5时，敏感性为98.0%，特异性为64.8%。改良Hijdra评分的诊断效能为93.24%，阴性预测值为84.29%，而Hijdra评分的诊断效能为85.34%，阴性预测值为48.89%。改良Hijdra评分在预测动脉瘤患者预后方面的AUC为0.824，在临界值为16.5时，敏感性为84.3%，特异性为70.0%。在CTA阴性的患者中，动脉瘤性SAH患者（15.48±3.93）的改良Hijdra评分显著高于非动脉瘤性SAH患者（6.31±4.52）（P < 0.0001）。
结论
改良Hijdra评分是辅助诊断和预测动脉瘤性蛛网膜下腔出血预后的有价值工具。
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