Can ‘noisy data’ perform as well as ‘clean data’ in outcome modeling after aneurysmal subarachnoid haemorrhage?

BACKGROUND: Baroreflex sensitivity (BRS) is associated with clinical outcome in patients with aneurysmal subarachnoid haemorrhage (aSAH); however few studies have investigated this in typical clinical settings. This two-centre study evaluated how outcome models differ when excluding patients who received beta-blockers and/or noradrenaline ('clean data' set) versus including all of them ('noisy data' set). METHODS: This retrospective study included consecutive aSAH patients from Addenbrooke's Hospital (UK) and Wroclaw Medical University (Poland). Early BRS was measured using the cross-correlation method. A favorable outcome was defined as a Glasgow Outcome Scale (GOS) score of 4-5 at discharge. RESULTS: = 32.27; p < 0.001, AUC = 0.84) included BRS (OR 1.10, 95%CI [1.01,1.20]) and GCS (OR 1.32, 95%CI [1.16,1.51]). CONCLUSIONS: Early BRS was independently associated with short-term outcome after aSAH, regardless of beta-blockers or noradrenaline use. In the 'clean data' set, HR was significantly associated with outcome, whilst in the 'noisy data' set, BRS was significantly associated with outcome. A larger multicentre study is required to validate these findings.