Biburger L, Mers L, Bogdanova A, Sekita A, Borutta M, Delev D, Bozhkov Y, Schnell O, Engelhorn T, Singer L, Sprügel M, Schwab S, Gerner S (2026)
Publication Type: Journal article
Publication year: 2026
Book Volume: 16
Article Number: 28
Journal Issue: 1
Background/Objectives: Several imaging scores have been developed for subarachnoid hemorrhage (SAH), but their prognostic performance for long-term functional outcome and post-hospital complications remains insufficiently characterized. We evaluated whether five admission imaging scores (modified Fisher, Claassen, Hijdra, Graeb, IVH) independently predict 12-month functional outcome and major secondary endpoints. Methods: We performed a retrospective cohort study of 479 consecutive patients with atraumatic SAH recorded in a prospectively maintained institutional registry. Admission CT/MRI was scored by two board-certified neuroradiologists blinded to clinical outcomes. The primary endpoint was unfavorable functional outcome at 12 months (modified Rankin scale [mRS] 4–6). Secondary endpoints included 12-month mortality, delayed cerebral ischemia (DCI), post-hemorrhagic epilepsy, shunt-dependent hydrocephalus, return to work, and patient-reported health. Receiver operating characteristic (ROC) analyses and multivariable logistic regression adjusted for established predictors were conducted. Results: All imaging scores were significantly associated with the primary endpoint and demonstrated adequate discrimination (area under the curve [AUC] ~0.70–0.74), with the Graeb and IVH scores performing highest for long-term functional outcome, mortality, and shunt dependence. Associations with DCI and epilepsy were modest. In multivariable analyses, all imaging scores remained independently associated with mRS 4–6. Subgroup analyses showed stronger prognostic performance in good-grade SAH, aneurysmal SAH, and cases with concomitant intraventricular hemorrhage. Conclusions: Admission imaging burden independently predicts 12-month functional outcome, mortality, and shunt dependence after SAH. Incorporating IVH-oriented measures alongside established clinical grading may improve individualized risk stratification, particularly in good-grade and aneurysmal SAH.
APA:
Biburger, L., Mers, L., Bogdanova, A., Sekita, A., Borutta, M., Delev, D.,... Gerner, S. (2026). Imaging Scores in Subarachnoid Hemorrhage: Performance on Prediction of Functional Outcome, Mortality, and Complications. Brain Sciences, 16(1). https://doi.org/10.3390/brainsci16010028
MLA:
Biburger, Luise, et al. "Imaging Scores in Subarachnoid Hemorrhage: Performance on Prediction of Functional Outcome, Mortality, and Complications." Brain Sciences 16.1 (2026).
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