Systematic review of clinical prediction tools and prognostic factors in aneurysmal subarachnoid hemorrhage.

Yusuke Nishimura,Mitchella H Levine,Lehana Thabane,Hitoshi Fukuda,Forough Farrokhyar,Benjaminw Y Lo

doi:10.4103/2152-7806.162676

Abstract

Background:Clinical prediction tools assist in clinical outcome prediction. They quantify the relative contributions of certain variables and condense information that identifies important indicators or predictors to a targeted condition. This systematic review synthesizes and critically appraises the methodologic quality of studies that derive both clinical predictors and clinical predictor tools used to determine outcome prognosis in patients suffering from aneurysmal subarachnoid hemorrhage (SAH).Methods:This systematic review included prospective and retrospective cohort studies, and randomized controlled trials (RCTs) investigating prognostic factors and clinical prediction tools associated with determining the neurologic outcome in adult patients with aneurysmal SAH.Results:Twenty-two studies were included in this systemic review. Independent, confounding, and outcome variables were studied. Methodologic quality of individual studies was also analyzed. Included were 3 studies analyzing databases from RCTs, 8 prospective cohort studies, and 11 retrospective cohort studies. The most frequently retained significant clinical prognostic factors for long-term neurologic outcome prediction include age, neurological grade, blood clot thickness, and aneurysm size.Conclusions:Systematic reviews for clinical prognostic factors and clinical prediction tools in aneurysmal SAH face a number of methodological challenges. These include within and between study patient heterogeneity, regional variations in treatment protocols, patient referral biases, and differences in treatment, and prognosis viewpoints across different cultures.

Highlights

Clinical prediction tools assist in clinical outcome prediction
This systematic review synthesizes and critically appraises methodologic quality of studies that derive both clinical predictors and clinical predictor tools used to determine outcome prognosis in patients suffering from aneurysmal subarachnoid hemorrhage
The purpose of this systematic review is to synthesize and critically appraise methodologic quality of studies that derive both clinical predictor tools and clinical predictors used to determine outcome prognosis in patients suffering from aneurysmal subarachnoid hemorrhage (SAH), with inclusion of studies with data generated from both prospective and retrospective cohort studies, and randomized controlled trials (RCTs)

Summary

Introduction

This systematic review synthesizes and critically appraises methodologic quality of studies that derive both clinical predictors and clinical predictor tools used to determine outcome prognosis in patients suffering from aneurysmal subarachnoid hemorrhage. Clinical prediction tools assist in clinical outcome prediction, in establishing the likelihood of presence or absence of a condition, as well as in determining potential therapeutic courses of action. Clinical prediction tools assist in clinical outcome prediction They quantify the relative contributions of certain variables and condense information that identifies important indicators or predictors to a targeted condition. This systematic review synthesizes and critically appraises the methodologic quality of studies that derive both clinical predictors and clinical predictor tools used to determine outcome prognosis in patients suffering from aneurysmal subarachnoid hemorrhage (SAH)

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Methods

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Discussion

Conclusion