Patient Phenotypes Associated With Outcomes After Aneurysmal Subarachnoid Hemorrhage

Abstract

Background and Purpose-Predictors of outcome after aneurysmal subarachnoid hemorrhage have been determined previously through hypothesis-driven methods that often exclude putative covariates and require a priori knowledge of potential confounders. Here, we apply a data-driven approach, principal component analysis, to identify baseline patient phenotypes that may predict neurological outcomes. Methods-Principal component analysis was performed on 120 subjects enrolled in a prospective randomized trial of clazosentan for the prevention of angiographic vasospasm. Correlation matrices were created using a combination of Pearson, polyserial, and polychoric regressions among 46 variables. Scores of significant components (with eigenvalues >1) were included in multivariate logistic regression models with incidence of severe angiographic vasospasm, delayed ischemic neurological deficit, and long-term outcome as outcomes of interest. Results-Sixteen significant principal components accounting for 74.6% of the variance were identified. A single component dominated by the patients' initial hemodynamic status, World Federation of Neurosurgical Societies score, neurological injury, and initial neutrophil/leukocyte counts was significantly associated with poor outcome. Two additional components were associated with angiographic vasospasm, of which one was also associated with delayed ischemic neurological deficit. The first was dominated by the aneurysm-securing procedure, subarachnoid clot clearance, and intracerebral hemorrhage, whereas the second had high contributions from markers of anemia and albumin levels. Conclusions-Principal

Identification of microRNA expression profile related to lymph node status in women with early-stage grade 1–2 endometrial cancer

“…20 Principal component analysis and biplot plotting were performed using custom code in R 3.1.3 software, available online.…”

Operative complications and differences in outcome after clipping and coiling of ruptured intracranial aneurysms

“…3,13,14,31 To reduce the risk of rehemorrhage, the ruptured aneurysm is treated either by neurosurgical clipping 29 or endovascular coiling. 16,28,30 Since publication of the International Subarachnoid Aneurysm Trial (ISAT) 30 in 2002, endovascular coiling has gained wide acceptance and has become the preferred treatment modality at many centers.…”

The network topology of aneurysmal subarachnoid haemorrhage

“…Variables that clustered within the same subnetwork as neurological outcome included measures of clinical and radiographic disease severity and poor clinical course. A previous data-driven principal component analysis of the same data set identified similar associations with outcome 2. Furthermore, all these covariates have been previously associated with outcomes in independent studies.…”

“…A z-score was derived for the laboratory values to represent their deviation from normal ranges published by the Canadian Medical Council. As we have shown previously, this approach places greater weights on values that deviate from normal ranges 2. To centre the means of other dimensions (such as subarachnoid and intraventricular clot burden), a z-score was derived from the sample distribution.…”