Outcome prediction in aneurysmal subarachnoid hemorrhage with world federation of neurological societies grade V (OPAS-V)

Yamada, Shuhei; Nishida, Takeo; Takenaka, Tomofumi; Yamazaki, Hiroki; Nakagawa, Ryota; Takagaki, Masatoshi; Yano, Yoshihiro; Nakamura, Hajime; Toyota, Shingo; Fujinaka, Toshiyuki; Taki, Takuyu; Fujita, Toshiaki; Kishima, Haruhiko

doi:https://doi.org/10.1007/s00701-025-06611-7

Outcome prediction in aneurysmal subarachnoid hemorrhage with world federation of neurological societies grade V (OPAS-V)

Yamada, Shuhei; Nishida, Takeo; Takenaka, Tomofumi et al.

Acta Neurochirurgica, 2025, 167(200)

アクセス数:27件（2025-10-18 15:59 集計）

固定URL: https://hdl.handle.net/11094/102741

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タイトル	Outcome prediction in aneurysmal subarachnoid hemorrhage with world federation of neurological societies grade V (OPAS-V)
著者	NRID 1000090885518 1000090885518 ORCID 0000-0002-5734-9620 0000-0002-5734-9620 researchmap permalink shuhei_yamada shuhei_yamada Scopus Author ID 57225713057 57225713057 著者名 Yamada, Shuhei
	著者名 Nishida, Takeo
	NRID 1000060869527 1000060869527 著者名 Takenaka, Tomofumi
	NRID 1000030995890 1000030995890 Scopus Author ID 57221289104 57221289104 著者名 Yamazaki, Hiroki
	NRID 1000050889920 1000050889920 researchmap permalink r-nakagawa r-nakagawa Scopus Author ID 57998446000 57998446000 著者名 Nakagawa, Ryota
	NRID 1000070724433 1000070724433 researchmap permalink osakansmt osakansmt Scopus Author ID 46261664000 46261664000 著者名 Takagaki, Masatoshi
	著者名 Yano, Yoshihiro
	NRID 1000080533794 1000080533794 researchmap permalink hnns-osaka hnns-osaka Scopus Author ID 55624478238 55624478238 著者名 Nakamura, Hajime
	著者名 Toyota, Shingo
	NRID 1000000359845 1000000359845 著者名 Fujinaka, Toshiyuki
	著者名 Taki, Takuyu
	著者名 Fujita, Toshiaki
	NRID 1000010332743 1000010332743 ORCID 0000-0002-9041-2337 0000-0002-9041-2337 researchmap permalink hkishima hkishima Scopus Author ID 6603783358 6603783358 著者名 Kishima, Haruhiko
キーワード等	Multicenter study
	Prediction
	Prognosis
	Subarachnoid hemorrhage
	WFNS grade V
内容	The version of record of this article, first published in Acta Neurochirurgica 167 (2025), is available online at Publisher’s website: https://doi.org/10.1007/s00701-025-06611-7.
抄録	Background: Aneurysmal subarachnoid hemorrhage (aSAH) with World Federation of Neurological Societies (WFNS) grade V has a high mortality rate and poor prognosis. Some patients with WFNS grade V aSAH have had good outcomes after aggressive treatment; however, outcome predictions based on routine examinations and findings obtained at admission are yet to be reported. This study aimed to develop a decision tree model for predicting outcomes of patients with WFNS grade V aSAH to aid decision-making for treatment strategy. Method: A multicenter study with retrospective and prospective data collected from 201 (derivation cohort) and 26 (validation cohort) patients with WFNS grade V aSAH, respectively, was conducted. Clinical outcomes were divided into good (Modified Rankin Scale [mRS] score at the time of discharge: 0–2) and poor (mRS score: 3–6) outcomes. A decision tree model was developed for the derivation cohort using the classification and regression tree method with clinical data including laboratory findings; it was named OPAS-V (Outcome Prediction in Aneurysmal Subarachnoid hemorrhage with WFNS grade V). The performance of the model was evaluated by area under the curve (AUC) and overall accuracy in both cohorts. Results: OPAS-V comprised 3 metrics; the percentage of lymphocytes (< 49.9% or not), age (> 50 yrs or not), and glucose to potassium ratio (≥ 3.2 or not). The model achieved an AUC of 0.828 (95% confidence interval: 0.712–0.944) and overall accuracy of 0.930. Moreover, the model performed well in the validation cohort with an AUC of 0.727 (95% confidence interval: 0.441–1) and overall accuracy of 0.885. Conclusions: This study developed the first decision tree model for predicting outcomes of patients with WFNS grade V aSAH, based on simple findings obtained at admission. This may aid clinicians in determining treatment strategies for severe conditions such as WFNS grade V aSAH.
出版者	Springer
収録物名	Acta Neurochirurgica
巻(号)	167(200)
刊行年月	2025-07-24
言語	英語
ハンドルURL	https://hdl.handle.net/11094/102741
PISSN	00016268
eISSN	09420940
関連情報 (isIdenticalTo)	DOI (出版社版) https://doi.org/10.1007/s00701-025-06611-7
アクセス権	open access
権利情報	This article is licensed under a Creative Commons Attribution 4.0 International License.
出版タイプ	Version of Record
カテゴリ	学術雑誌論文 Journal Article

資源タイプ	学術雑誌論文
ローカル資源タイプ	学術雑誌論文
DCMI資源タイプ	text
DCTERMS.bibliographicCitation	Acta Neurochirurgica. 2025, 167(200)
DC.title	Outcome prediction in aneurysmal subarachnoid hemorrhage with world federation of neurological societies grade V (OPAS-V)
DC.creator	Yamada, Shuhei
	Nishida, Takeo
	Takenaka, Tomofumi
	Yamazaki, Hiroki
	Nakagawa, Ryota
	Takagaki, Masatoshi
	Yano, Yoshihiro
	Nakamura, Hajime
	Toyota, Shingo
	Fujinaka, Toshiyuki
	Taki, Takuyu
	Fujita, Toshiaki
	Kishima, Haruhiko
DC.publisher	Springer
DC.language' scheme='DCTERMS.RFC1766	英語
DC.type' scheme='DCTERMS.DCMIType	text
DCTERMS.issued' scheme='DCTERMS.W3CDTF	2025-07-24
DC.identifier	https://doi.org/10.1007/s00701-025-06611-7
DC.subject	Multicenter study
	Prediction
	Prognosis
	Subarachnoid hemorrhage
	WFNS grade V
DC.description	The version of record of this article, first published in Acta Neurochirurgica 167 (2025), is available online at Publisher’s website: https://doi.org/10.1007/s00701-025-06611-7.
DCTERMS.abstract	Background: Aneurysmal subarachnoid hemorrhage (aSAH) with World Federation of Neurological Societies (WFNS) grade V has a high mortality rate and poor prognosis. Some patients with WFNS grade V aSAH have had good outcomes after aggressive treatment; however, outcome predictions based on routine examinations and findings obtained at admission are yet to be reported. This study aimed to develop a decision tree model for predicting outcomes of patients with WFNS grade V aSAH to aid decision-making for treatment strategy. Method: A multicenter study with retrospective and prospective data collected from 201 (derivation cohort) and 26 (validation cohort) patients with WFNS grade V aSAH, respectively, was conducted. Clinical outcomes were divided into good (Modified Rankin Scale [mRS] score at the time of discharge: 0–2) and poor (mRS score: 3–6) outcomes. A decision tree model was developed for the derivation cohort using the classification and regression tree method with clinical data including laboratory findings; it was named OPAS-V (Outcome Prediction in Aneurysmal Subarachnoid hemorrhage with WFNS grade V). The performance of the model was evaluated by area under the curve (AUC) and overall accuracy in both cohorts. Results: OPAS-V comprised 3 metrics; the percentage of lymphocytes (< 49.9% or not), age (> 50 yrs or not), and glucose to potassium ratio (≥ 3.2 or not). The model achieved an AUC of 0.828 (95% confidence interval: 0.712–0.944) and overall accuracy of 0.930. Moreover, the model performed well in the validation cohort with an AUC of 0.727 (95% confidence interval: 0.441–1) and overall accuracy of 0.885. Conclusions: This study developed the first decision tree model for predicting outcomes of patients with WFNS grade V aSAH, based on simple findings obtained at admission. This may aid clinicians in determining treatment strategies for severe conditions such as WFNS grade V aSAH.
DC.rights	This article is licensed under a Creative Commons Attribution 4.0 International License.
DC.format	102741
citation_title	Outcome prediction in aneurysmal subarachnoid hemorrhage with world federation of neurological societies grade V (OPAS-V)
citation_author	Yamada, Shuhei
	Nishida, Takeo
	Takenaka, Tomofumi
	Yamazaki, Hiroki
	Nakagawa, Ryota
	Takagaki, Masatoshi
	Yano, Yoshihiro
	Nakamura, Hajime
	Toyota, Shingo
	Fujinaka, Toshiyuki
	Taki, Takuyu
	Fujita, Toshiaki
	Kishima, Haruhiko
citation_publisher	Springer
citation_language	英語
citation_date	2025-07-24
citation_journal_title	Acta Neurochirurgica
citation_volume	167
citation_issue	200
citation_doi	https://doi.org/10.1007/s00701-025-06611-7
citation_public_url	https://hdl.handle.net/11094/102741

Outcome prediction in aneurysmal subarachnoid hemorrhage with world federation of neurological societies grade V (OPAS-V)

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