Possibilities of mathematical definition of unfavourable course of subarachnoid haemorrhage in the acute period

Abstract

Subarachnoid haemorrhage (SAH) is associated with a 30-day mortality rate of 50% and is one of the most life-threatening cerebrovascular diseases. Objective. Toevaluatetheprognosticsignificance and informativeness of some clinical indicators, highlighting the most optimal and reliable potential factors in the development of a mathematical equation for calculating the personal probability of complications in patients with subarachnoid hemorrhage of atraumatic etiology. Materials and methods. A clinical experimental study involved 87 patients with SAH, 44 were men, 43 – women. On the first day after SAH, half of the patients were hospitalized – 46 people (52,87%). Results. The constructed model for calculating the probability of events such as secondary ischemia, hydrocephalus, or cerebral vasospasm over the next 14 days indicates the correctness and adequacy of the constructed model of logistic regression.The personal probability of a complication is calculated by the formula: p = 1 / (1 + e-z), where p is the % probability of a complication of SAH; z = –45,5 + 17,5* Copeptine –0.44 × Na + 0,06 × Age + 1,99 × Ball (Hunt-Hess). Conclusions. The prognostic model allows us to consider that secondary ischemia and cerebral vasospasm are not only predictors of poor prognosis and potential factors for the formation of complications, but also are indicators for the correct determination of individual cumulative risk in SAH. Keywords: notraumatic hemorrhage, C. S. Ogilvy, copeptin, SIADH syndrome, hyponatremia, prognosis, logistic regression.