目的:SAFIRE分级量表是一种新颖的,可计算量表可预测动脉瘤性蛛网膜下腔出血(aSAH)患者的急性随访结果。然而,该量表在长期随访中也可能具有预后意义,并有助于指导进一步的治疗.
方法:对所有参加Barrow破裂动脉瘤试验(BRAT)患者的记录进行回顾性分析,患者被分配SAFIRE等级。分析了每个SAFIRE年级的aSAH后1年和6年的结果,不良结局定义为改良的Rankin量表评分>2。在1年和6年的随访中,对SAFIRE分级高(IV或V)的患者进行了单变量分析,以了解不良预后的几率。
结果:共405例确诊aSAH患者纳入BRAT进行分析;357例患者进行了1年随访,333例患者有6年的随访数据.一般来说,随着SAFIRE等级的提高,结果不佳的患者比例也是如此。在1年的随访中,18%(17/93)的Ⅰ级患者,22%(20/92)的Ⅱ级患者,32%(26/80)的Ⅲ级患者,43%(38/88)的Ⅳ级患者,发现75%(3/4)的V级患者结局不佳。在6年的随访中,29%(23/79)的Ⅰ级患者,24%(21/89)的II级患者,38%(29/77)的Ⅲ级患者,60%(50/84)的IV级患者,发现100%(4/4)的V级患者结局不佳。单因素分析显示,SAFIRE等级IV或V与1年(OR2.5,95%CI1.5-4.2;p<0.001)和6年(OR3.7,95%CI2.2-6.2;p<0.001)随访时不良结局的风险显着增加。
结论:高SAFIRE评分与后期随访恢复不良的风险增加相关。
The
SAFIRE grading scale is a novel, computable scale that predicts the outcome of aneurysmal subarachnoid hemorrhage (aSAH) patients in acute follow-up. However, this scale also may have prognostic significance in long-term follow-up and help guide further management.
The records of all patients enrolled in the Barrow Ruptured Aneurysm Trial (BRAT) were retrospectively reviewed, and the patients were assigned
SAFIRE grades. Outcomes at 1 year and 6 years post-aSAH were analyzed for each
SAFIRE grade level, with a poor outcome defined as a modified Rankin Scale score > 2. Univariate analysis was performed for patients with a high SAFIRE grade (IV or V) for odds of poor outcome at the 1- and 6-year follow-ups.
A total of 405 patients with confirmed aSAH enrolled in the BRAT were analyzed; 357 patients had 1-year follow-up, and 333 patients had 6-year follow-up data available. Generally, as the
SAFIRE grade increased, so did the proportion of patients with poor outcomes. At the 1-year follow-up, 18% (17/93) of grade I patients, 22% (20/92) of grade II patients, 32% (26/80) of grade III patients, 43% (38/88) of grade IV patients, and 75% (3/4) of grade V patients were found to have poor outcomes. At the 6-year follow-up, 29% (23/79) of grade I patients, 24% (21/89) of grade II patients, 38% (29/77) of grade III patients, 60% (50/84) of grade IV patients, and 100% (4/4) of grade V patients were found to have poor outcomes. Univariate analysis showed that a SAFIRE grade of IV or V was associated with a significantly increased risk of a poor outcome at both the 1-year (OR 2.5, 95% CI 1.5-4.2; p < 0.001) and 6-year (OR 3.7, 95% CI 2.2-6.2; p < 0.001) follow-ups.
High
SAFIRE grades are associated with an increased risk of a poor recovery at late follow-up.