Key result
The modified WFNS scale accurately predicted 90-day poor outcomes (AUROC 0.839), with grades III to V showing a stronger association with poor outcomes (AOR 9.090) than WFNS or Hunt and Hess scales.
Why the study?
Grading systems help predict prognosis and guide treatment decisions in aneurysmal subarachnoid hemorrhage, but the comparative predictive accuracy of the modified WFNS, WFNS, and Hunt and Hess scales required evaluation.
Does the modified WFNS grading scale accurately predict 90-day poor outcomes compared to the original WFNS and H&H scales in adult patients with aneurysmal subarachnoid hemorrhage?
Cohort (n=415)
Yes
Does the modified WFNS grading scale accurately predict 90-day poor outcomes compared to the original WFNS and H&H scales in adult patients with aneurysmal subarachnoid hemorrhage?
Odds Ratio: 9.09 (95% CI 3.494–23.648)
p-value: p=<0.001
The modified WFNS, original WFNS, and Hunt and Hess scales all demonstrate good and comparable discriminatory ability for predicting 90-day outcomes in aneurysmal subarachnoid hemorrhage, though the modified WFNS may offer a better effect size for predicting poor outcomes.
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Modified WFNS may aid 90-day prognostication in aSAH; leaves open superiority over WFNS or Hunt-Hess pending prospective validation.
Nguyen et al. (2023) conducted a cohort in Aneurysmal subarachnoid hemorrhage (aSAH) (n=415). Modified WFNS grading scale vs. WFNS and Hunt and Hess scales was evaluated on 90-day poor outcome (mRS 4-6) (AOR 9.090, 95% CI 3.494-23.648, p=<0.001). The modified WFNS scale accurately predicted 90-day poor outcomes (AUROC 0.839), with grades III to V showing a stronger association with poor outcomes (AOR 9.090) than WFNS or Hunt and Hess scales.
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