Su Chang, Ye Jianping, Liu Jin
Department of Neurosurgery, Lishui Hospital of Wenzhou Medical University, Lishui, China.
Department of Intensive Care Unit, Lishui Hospital of Wenzhou Medical University, Lishui, China.
Front Neurol. 2025 Mar 12;16:1535654. doi: 10.3389/fneur.2025.1535654. eCollection 2025.
Delayed cerebral ischemia (DCI) is a frequent consequence of aneurysmal subarachnoid hemorrhage (aSAH), and severe aSAH is typically accompanied with Acute Lung Injury (ALI). This research examined the risk variables for delayed cerebral ischaemia in aneurysmal subarachnoid hemorrhage patients complicated with ALI, and developed a columnar graph prediction model.
Clinical data from 234 patients with aSAH complicated with ALI, admitted to Lishui People's Hospital between January 2018 and June 2024, were analyzed. The patients were randomly divided into a training group (164 cases) and a validation group (70 cases). Risk factors for the occurrence of delayed cerebral ischaemia (DCI) were identified and incorporated into a model, the differentiation and reliability of the line graph model were validated via the use of ROC curves and calibration curves.
Multifactorial logistic regression identified three significant independent risk variables for DCI: elevated positive end-expiratory pressure (PEEP), interleukin-6, and D-dimer ( < 0.05). The column-line plots demonstrated superior discriminatory performance in both the training set (AUC = 0.882, 95% CI: 0.820-0.940) and the validation set (AUC = 0.874, 95% CI: 0.778-0.996), while the calibration curves indicated strong concordance between the training and validation sets.
High positive end-expiratory pressure, interleukin-6, and d-dimer are independent risk factors for DCI in patients with aSHA combined with ALI, and the resulting columnar line graphs show significant predictive value and help to better identify patients at high risk of DCI.
迟发性脑缺血（DCI）是动脉瘤性蛛网膜下腔出血（aSAH）的常见后果，严重的aSAH通常伴有急性肺损伤（ALI）。本研究探讨了合并ALI的aSAH患者发生迟发性脑缺血的风险变量，并建立了柱状图预测模型。
分析了2018年1月至2024年6月在丽水市人民医院住院的234例合并ALI的aSAH患者的临床资料。将患者随机分为训练组（164例）和验证组（70例）。确定迟发性脑缺血（DCI）发生的危险因素并纳入模型，通过ROC曲线和校准曲线验证线图模型的区分度和可靠性。
多因素logistic回归确定了DCI的三个显著独立风险变量：呼气末正压（PEEP）升高、白细胞介素-6和D-二聚体（P<0.05）。柱状线图在训练集（AUC=0.882，95%CI：0.820-0.940）和验证集（AUC=0.874，95%CI：0.778-0.996）中均表现出优异的区分性能，而校准曲线表明训练集和验证集之间具有高度一致性。
高呼气末正压、白细胞介素-6和D-二聚体是合并ALI的aSHA患者发生DCI的独立危险因素，由此产生的柱状线图显示出显著的预测价值，有助于更好地识别DCI高危患者。
