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

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.…”

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.…”

Lessons from the CONSCIOUS-1 Study

“…We used several methods that have seldom been used to investigate aSAH. Patient phenotypes that predict poor neurological outcomes following SAH were identified using principal component analysis [ 100 ]. Hemodynamic status, WFNS score, neurological injury and initial neutrophil/leukocyte counts were associated with poor outcomes.…”

Pulse wave velocity, augmentation index, and carotid intima-media thickness are each associated with different inflammatory protein signatures in young healthy adults: The lifestyle, biomarkers and atherosclerosis study

“…inflammatory proteins correlate with physiological measurements of vascular structure and function in young and otherwise healthy adults. We used PCA to achieve manageable data reduction and take into account the multiple collinearity that is expected when employing a proteomics panel that simultaneously measures several proteins that are all related to certain pre-defined pathways of the inflammatory responses [19]. Among the four PCs obtained, PC 3 was inversely associated with PWV, PC 2 was associated with AIX and PC 4 was associated with cIMT.…”

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.…”

Lessons from the CONSCIOUS-1 Study

“…We used several methods that have seldom been used to investigate aSAH. Patient phenotypes that predict poor neurological outcomes following SAH were identified using principal component analysis [ 100 ]. Hemodynamic status, WFNS score, neurological injury and initial neutrophil/leukocyte counts were associated with poor outcomes.…”

Pulse wave velocity, augmentation index, and carotid intima-media thickness are each associated with different inflammatory protein signatures in young healthy adults: The lifestyle, biomarkers and atherosclerosis study

“…inflammatory proteins correlate with physiological measurements of vascular structure and function in young and otherwise healthy adults. We used PCA to achieve manageable data reduction and take into account the multiple collinearity that is expected when employing a proteomics panel that simultaneously measures several proteins that are all related to certain pre-defined pathways of the inflammatory responses [19]. Among the four PCs obtained, PC 3 was inversely associated with PWV, PC 2 was associated with AIX and PC 4 was associated with cIMT.…”

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.…”

Lessons from the CONSCIOUS-1 Study

“…We used several methods that have seldom been used to investigate aSAH. Patient phenotypes that predict poor neurological outcomes following SAH were identified using principal component analysis [ 100 ]. Hemodynamic status, WFNS score, neurological injury and initial neutrophil/leukocyte counts were associated with poor outcomes.…”

Pulse wave velocity, augmentation index, and carotid intima-media thickness are each associated with different inflammatory protein signatures in young healthy adults: The lifestyle, biomarkers and atherosclerosis study

“…inflammatory proteins correlate with physiological measurements of vascular structure and function in young and otherwise healthy adults. We used PCA to achieve manageable data reduction and take into account the multiple collinearity that is expected when employing a proteomics panel that simultaneously measures several proteins that are all related to certain pre-defined pathways of the inflammatory responses [19]. Among the four PCs obtained, PC 3 was inversely associated with PWV, PC 2 was associated with AIX and PC 4 was associated with cIMT.…”