Constructing a nomogram for short-term prognosis in postoperative patients with aneurysmal subarachnoid hemorrhage: a two-center retrospective study

Abstract Aneurysmal subarachnoid hemorrhage (aSAH) is a life-threatening condition with high morbidity and mortality. Early prediction of prognosis remains challenging. This study aimed to develop a nomogram incorporating clinical and inflammatory biomarkers to predict short-term outcomes in postope...

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Main Authors: Yingcong Wei, Xiaoyong Lin, Mingjian Lin, Wencai Li, Honghai Luo, Gang Zhu
Format: Article
Language:English
Published: Nature Portfolio 2025-08-01
Series:Scientific Reports
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Online Access:https://doi.org/10.1038/s41598-025-11894-y
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author Yingcong Wei
Xiaoyong Lin
Mingjian Lin
Wencai Li
Honghai Luo
Gang Zhu
author_facet Yingcong Wei
Xiaoyong Lin
Mingjian Lin
Wencai Li
Honghai Luo
Gang Zhu
author_sort Yingcong Wei
collection DOAJ
description Abstract Aneurysmal subarachnoid hemorrhage (aSAH) is a life-threatening condition with high morbidity and mortality. Early prediction of prognosis remains challenging. This study aimed to develop a nomogram incorporating clinical and inflammatory biomarkers to predict short-term outcomes in postoperative aSAH patients. Thus optimizing the intervention strategy and improve patient quality of life. Logistic regression analysis was used to determine the single predictor of aneurysmal subarachnoid hemorrhage. Based on these independent predictors, a nomogram was created in R studio. The results showed that the aneurysmal site (3.35[95% CI, 1.05–10.66], P = 0.041), affected side (3.77[95% CI, 1.17–12.11], P = 0.026), hydrocephalus (0.03[95% CI, 0.01–0.12], P < 0.001), Hunt-Hess grade (4.13[95% CI, 1.17–14.49], P = 0.027), GCS score (4.08[95% CI, 1.02–16.25], P = 0.046), hypertension history (0.18[95% CI, 0.06–0.55], P = 0.003), WBC (3.49[95% CI, 1.06–11.56], P = 0.04), MLR (0.33[95% CI, 0.12–0.92], P = 0.035) were independent predictors. The nomogram demonstrated superior predictive accuracy compared to existing models, with lower calibration errors (training group: 0.018; validation group: 0.052) and high AUC values (0.95 and 0.901, respectively). Given the class imbalance (84.3% of patients had favorable outcomes), sensitivity analyses were performed to verify the consistency and reliability of the findings. The nomogram constructed based on aneurysm location, affected side, presence of hydrocephalus, Hunt-Hess grade, GCS score, hypertension, WBC and MLR can enables clinicians to identify high-risk aSAH patients early, facilitating targeted interventions such as anti-inflammatory therapy or hydrocephalus management. This tool may improve resource allocation and reduce disability rates in critical care settings. Thus optimizing the intervention strategy and improve patient quality of life.
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spelling doaj-art-1c1eecfa0ca04e1dab43f849989a7c6d2025-08-20T03:46:00ZengNature PortfolioScientific Reports2045-23222025-08-0115112010.1038/s41598-025-11894-yConstructing a nomogram for short-term prognosis in postoperative patients with aneurysmal subarachnoid hemorrhage: a two-center retrospective studyYingcong Wei0Xiaoyong Lin1Mingjian Lin2Wencai Li3Honghai Luo4Gang Zhu5Guangdong Medical UniversityGuangdong Medical UniversityDept. Neurosurgery, Gaozhou People’s HospitalDept. Neurosurgery, Huizhou Central People’s HospitalDept. Neurosurgery, Huizhou Central People’s HospitalDept. Neurosurgery, Huizhou Central People’s HospitalAbstract Aneurysmal subarachnoid hemorrhage (aSAH) is a life-threatening condition with high morbidity and mortality. Early prediction of prognosis remains challenging. This study aimed to develop a nomogram incorporating clinical and inflammatory biomarkers to predict short-term outcomes in postoperative aSAH patients. Thus optimizing the intervention strategy and improve patient quality of life. Logistic regression analysis was used to determine the single predictor of aneurysmal subarachnoid hemorrhage. Based on these independent predictors, a nomogram was created in R studio. The results showed that the aneurysmal site (3.35[95% CI, 1.05–10.66], P = 0.041), affected side (3.77[95% CI, 1.17–12.11], P = 0.026), hydrocephalus (0.03[95% CI, 0.01–0.12], P < 0.001), Hunt-Hess grade (4.13[95% CI, 1.17–14.49], P = 0.027), GCS score (4.08[95% CI, 1.02–16.25], P = 0.046), hypertension history (0.18[95% CI, 0.06–0.55], P = 0.003), WBC (3.49[95% CI, 1.06–11.56], P = 0.04), MLR (0.33[95% CI, 0.12–0.92], P = 0.035) were independent predictors. The nomogram demonstrated superior predictive accuracy compared to existing models, with lower calibration errors (training group: 0.018; validation group: 0.052) and high AUC values (0.95 and 0.901, respectively). Given the class imbalance (84.3% of patients had favorable outcomes), sensitivity analyses were performed to verify the consistency and reliability of the findings. The nomogram constructed based on aneurysm location, affected side, presence of hydrocephalus, Hunt-Hess grade, GCS score, hypertension, WBC and MLR can enables clinicians to identify high-risk aSAH patients early, facilitating targeted interventions such as anti-inflammatory therapy or hydrocephalus management. This tool may improve resource allocation and reduce disability rates in critical care settings. Thus optimizing the intervention strategy and improve patient quality of life.https://doi.org/10.1038/s41598-025-11894-yAneurysmal subarachnoid hemorrhageShort-term prognosisInflammatory factorNomogram
spellingShingle Yingcong Wei
Xiaoyong Lin
Mingjian Lin
Wencai Li
Honghai Luo
Gang Zhu
Constructing a nomogram for short-term prognosis in postoperative patients with aneurysmal subarachnoid hemorrhage: a two-center retrospective study
Scientific Reports
Aneurysmal subarachnoid hemorrhage
Short-term prognosis
Inflammatory factor
Nomogram
title Constructing a nomogram for short-term prognosis in postoperative patients with aneurysmal subarachnoid hemorrhage: a two-center retrospective study
title_full Constructing a nomogram for short-term prognosis in postoperative patients with aneurysmal subarachnoid hemorrhage: a two-center retrospective study
title_fullStr Constructing a nomogram for short-term prognosis in postoperative patients with aneurysmal subarachnoid hemorrhage: a two-center retrospective study
title_full_unstemmed Constructing a nomogram for short-term prognosis in postoperative patients with aneurysmal subarachnoid hemorrhage: a two-center retrospective study
title_short Constructing a nomogram for short-term prognosis in postoperative patients with aneurysmal subarachnoid hemorrhage: a two-center retrospective study
title_sort constructing a nomogram for short term prognosis in postoperative patients with aneurysmal subarachnoid hemorrhage a two center retrospective study
topic Aneurysmal subarachnoid hemorrhage
Short-term prognosis
Inflammatory factor
Nomogram
url https://doi.org/10.1038/s41598-025-11894-y
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