Quantitative electroencephalography predicts delayed cerebral ischemia after aneurysmal subarachnoid hemorrhage: a retrospective study

IF 1.9 4区医学 Q3 CLINICAL NEUROLOGY

Journal of Clinical Neuroscience Pub Date : 2025-04-26 DOI:10.1016/j.jocn.2025.111284

Mengyuan Xu , Pengzhao Zhang , Yang Liu , Jiaqi Zhang , Guang Feng , Bingsha Han

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引用次数: 0

Abstract

Purpose

Delayed cerebral ischemia (DCI) is a common complication that occurs in aneurysmal subarachnoid hemorrhage (aSAH). This complication can lead to clinical deterioration and poor prognosis. The aim of this study is to explore the risk factors for DCI in aSAH patients in neurological ICU, develop a nomogram including quantitative electroencephalography (qEEG) parameters, and evaluate its performance.

Methods

We retrospectively analyzed and processed Severe aneurysmal subarachnoid hemorrhage (SaSAH) patients from June 2022 to May 2024 who underwent bedside qEEG monitoring and analyzed the qEEG indices, brain CT, and clinical data of these patients. Logistic multivariate regression analysis was employed to identify the independent risk factors of DCI. A clinical prediction model in the form of a nomogram for DCI was developed using the R programming language and subsequently evaluated for its performance and quality.

Results

A total of 145 patients with SaSAH were included in the analysis, comprising 101 patients in the training set and 44 patients in the validation set. 77 patients (53.10 %) developed DCI. Multivariate regression analysis revealed that GCS, modified Fisher grade, hypothermia, alpha/delta ratio (ADR) and PAV grade were independent risk factors for DCI. The nomogram exhibited excellent discriminative performance in both the training set (AUC = 0.84) and the validation set (AUC = 0.80).

Conclusion

Quantitative EEG can predict DCI following SaSAH, the resulting nomogram demonstrated substantial predictive value and may help target therapies to patients at highest risk of secondary brain injury. It needs to be further confirmed in the future by multi-center large sample studies.

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定量脑电图预测动脉瘤性蛛网膜下腔出血后迟发性脑缺血：一项回顾性研究

目的延迟性脑缺血（DCI）是动脉瘤性蛛网膜下腔出血（aSAH）的常见并发症。这种并发症可导致临床恶化和预后不良。本研究旨在探讨神经内科ICU aSAH患者发生DCI的危险因素，制作包含定量脑电图（qEEG）参数的nomogram脑电图图，并对其性能进行评价。方法回顾性分析和处理2022年6月至2024年5月床边qEEG监测的重度动脉瘤性蛛网膜下腔出血（SaSAH）患者，分析其qEEG指标、脑CT及临床资料。采用Logistic多元回归分析确定DCI的独立危险因素。使用R编程语言开发了DCI的nomogram临床预测模型，并随后对其性能和质量进行了评估。结果145例SaSAH患者纳入分析，其中训练组101例，验证组44例。77例（53.10%）发生DCI。多因素回归分析显示，GCS、改良Fisher分级、低温、ADR和PAV分级是DCI的独立危险因素。在训练集（AUC = 0.84）和验证集（AUC = 0.80）上均表现出优异的判别性能。结论定量脑电图可以预测SaSAH后的DCI，所得到的脑图具有较强的预测价值，有助于对继发性脑损伤高危患者进行靶向治疗。这需要在未来的多中心大样本研究中进一步证实。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Clinical Neuroscience 医学-临床神经学

CiteScore

4.50

自引率

0.00%

发文量

402

审稿时长

40 days

期刊介绍： This International journal, Journal of Clinical Neuroscience, publishes articles on clinical neurosurgery and neurology and the related neurosciences such as neuro-pathology, neuro-radiology, neuro-ophthalmology and neuro-physiology. The journal has a broad International perspective, and emphasises the advances occurring in Asia, the Pacific Rim region, Europe and North America. The Journal acts as a focus for publication of major clinical and laboratory research, as well as publishing solicited manuscripts on specific subjects from experts, case reports and other information of interest to clinicians working in the clinical neurosciences.