BACKGROUND Long-term outcome after subarachnoid hemorrhage, beyond the first few months, is difficult to predict, but has critical relevance to patients, their families, and carers. OBJECTIVE To assess the performance of the Subarachnoid Hemorrhage International Trialists (SAHIT) prediction models, which were initially designed to predict short-term (90 d) outcome, as predictors of long-term (2 yr) functional outcome after aneurysmal subarachnoid hemorrhage (aSAH). METHODS We included 1545 patients with angiographically-proven aSAH from the Genetic and Observational Subarachnoid Haemorrhage (GOSH) study recruited at 22 hospitals between 2011 and 2014. We collected data on age, WNFS grade on admission, history of hypertension, Fisher grade, aneurysm size and location, as well as treatment modality. Functional outcome was measured by the Glasgow Outcome Scale (GOS) with GOS 1 to 3 corresponding to unfavorable and 4 to 5 to favorable functional outcome, according to the SAHIT models. The SAHIT models were assessed for long-term outcome prediction by estimating measures of calibration (calibration slope) and discrimination (area under the receiver-operating characteristic curve [AUC]) in relation to poor clinical outcome. RESULTS Follow-up was standardized to 2 yr using imputation methods. All 3 SAHIT models demonstrated acceptable predictive performance for long-term functional outcome. The estimated AUC was 0.71 (95% CI: 0.65-0.76), 0.73 (95% CI: 0.68-0.77), and 0.74 (95% CI: 0.69-0.79) for the core, neuroimaging, and full models, respectively; the calibration slopes were 0.86, 0.84, and 0.89, indicating good calibration. CONCLUSION The SAHIT prediction models, incorporating simple factors available on hospital admission, show good predictive performance for long-term functional outcome after aSAH.

中文翻译：

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在英国多中心队列研究中评估蛛网膜下腔出血国际试验 (SAHIT) 模型对动脉瘤性蛛网膜下腔出血后二分长期功能结果的预测

背景 蛛网膜下腔出血后的长期结果（超过最初几个月）很难预测，但与患者、他们的家人和护理人员有着至关重要的相关性。目的 评估蛛网膜下腔出血国际试验 (SAHIT) 预测模型的性能，该模型最初设计用于预测短期（90 天）结果，作为动脉瘤性蛛网膜下腔出血 (aSAH) 后长期（2 年）功能结果的预测因子）。方法 我们纳入了 2011 年至 2014 年在 22 家医院招募的遗传和观察性蛛网膜下腔出血 (GOSH) 研究中经血管造影证实的 1545 名 aSAH 患者。我们收集了有关年龄、入院时 WNFS 分级、高血压病史、Fisher 分级、动脉瘤大小的数据和位置，以及治疗方式。根据 SAHIT 模型，功能结果由格拉斯哥结果量表 (GOS) 测量，GOS 1 至 3 对应于不利的功能结果，而 4 至 5 对应于有利的功能结果。SAHIT 模型通过估计与不良临床结果相关的校准（校准斜率）和区分（接受者操作特征曲线 [AUC] 下的面积）的措施来评估长期结果预测。结果 使用插补方法将随访标准化为 2 年。所有 3 个 SAHIT 模型都显示出可接受的长期功能结果预测性能。核心、神经影像和完整模型的估计 AUC 分别为 0.71（95% CI：0.65-0.76）、0.73（95% CI：0.68-0.77）和 0.74（95% CI：0.69-0.79）；校准斜率分别为 0.86、0.84 和 0.89，表明校准良好。