NSQIP unruptured aneurysm scale [Neurosurgery Wiki]

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====== NSQIP unruptured aneurysm scale ======

{{::nsqip_unruptured_aneurysm_scale.jpeg?200|}}

[[Data]] on [[patient]]s who underwent surgical [[clipping]] of an [[unruptured]] [[aneurysm]] were extracted from the prospective [[National Surgical Quality Improvement Program]] registry (NSQIP; 2007-2014); NSQIP does not systematically collect data on patients undergoing intracranial [[endovascular]] [[intervention]]. [[Multivariable]] [[logistic regression]] evaluated [[predictor]]s of any 30-day [[adverse event]]; variables screened included patient [[demographics]], [[comorbidities]], [[functional status]], preoperative [[laboratory]] values, aneurysm location/complexity, and [[operative time]]. A predictive [[scale]] was constructed based on statistically significant independent predictors, which was validated using both NSQIP (2015-2016) and the [[Nationwide Inpatient Sample]] (NIS; 2002-2011).

The [[NSQIP unruptured aneurysm scale]] was proposed: 1 point was assigned for a bleeding disorder; 2 points for age 51-60 years, cardiac disease, diabetes mellitus, morbid obesity, anemia (hematocrit < 36%), operative time 240-330 minutes; 3 points for leukocytosis (white blood cell count > 12,000/μL) and operative time > 330 minutes; and 4 points for age > 60 years. An increased score was predictive of postoperative stroke or coma (NSQIP: p = 0.002, C-statistic = 0.70; NIS: p < 0.001, C-statistic = 0.61), a medical complication (NSQIP: p = 0.01, C-statistic = 0.71; NIS: p < 0.001, C-statistic = 0.64), and a nonroutine discharge (NSQIP: p < 0.001, C-statistic = 0.75; NIS: p < 0.001, C-statistic = 0.66) in both validation populations. Greater score was also predictive of increased [[odds]] of any [[adverse event]], a major [[complication]], and an extended [[hospitalization]] in both validation [[population]]s (p ≤ 0.03).

The NSQIP unruptured aneurysm scale may augment the risk stratification of patients undergoing microsurgical [[clipping]] of [[unruptured cerebral aneurysm]]s
((Dasenbrock HH, Rudy RF, Smith TR, Gormley WB, Patel NJ, Frerichs KU,
Aziz-Sultan MA, Du R. Adverse events after clipping of unruptured intracranial
aneurysms: the NSQIP unruptured aneurysm scale. J Neurosurg. 2019 Mar 15:1-10.
doi: 10.3171/2018.12.JNS182873. [Epub ahead of print] PubMed PMID: 30875693.
)).