Neuroanesthesia & neurocritical care
Predicting outcome after aneurysmal subarachnoid hemorrhage by exploitation of signal complexity: a prospective two-center cohort study
Authors' conclusion
MSE metrics and thereby complexity of physiological signals are independent, internally and externally valid predictors of 12-month outcome.
Study context
- Population
- Patients with aneurysmal SAHanalysed
- Participants
- 330 patients
- Exposure
- Multiscale entropy (MSE) of physiological signals as predictor of 12-month outcome
- Zurich-derivationn = 241
- Aachen-validationn = 89
- Outcome
- Dichotomized (GOSE 1-4 vs 5-8) or ordinal GOSE outcome
- Follow-up
- 12 months
Methodological detailstwo-centre, derivation and external validation cohorts, bootstrapping internal validation
- Two-centre
- Derivation and external validation cohorts
- Bootstrapping internal validation
Main finding
As reported in the abstract
Unfavorable outcome
- Decreasing MSE associated with higher likelihood of unfavorable outcome, independent of covariates and analysis method
- Multivariable adjusted logistic regression models well calibrated, only slight decrease in discrimination in validation cohort
- Ordinal analysis: effect of MSE linear
- MSE remained valid when outcome definition adjusted against initial severity
- Adjusted for age, WFNS grade, modified Fisher (mFisher) grade, delayed cerebral infarction
Observational data: associations, not effects.
Original publication
Predicting outcome after aneurysmal subarachnoid hemorrhage by exploitation of signal complexity: a prospective two-center cohort study. Crit Care. Published 14 May 2024. doi:10.
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