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DOI: 10.1055/s-0043-1776275
Comparison of Prognostic Performance between Fisher and Modified Fisher Scales for Patients with Aneurysmal Subarachnoid Hemorrhage
Comparação do desempenho prognóstico entre as escalas Fisher e Fisher modificada para pacientes com hemorragia subaracnóidea aneurismática Financial Support None to declare.Abstract
Objective The present study aims to assess and compare the prognostic value of these two scales for predicting mortality.
Method We reviewed 172 patients with aneurysmal subarachnoid hemorrhage, who were followed-up for 6 months. The Fisher and modified Fisher scales were evaluated for the prediction of mortality using logistic regressions.
Results The Fisher scale was associated with mortality (odds ratio [OR]: 2; 95% confidence interval [CI]: 1.09–4.05) in the multivariate analysis. The modified Fisher scale was not associated with mortality in the multivariate analysis (OR: 1.39; 95% CI: 0.9–2.29), nor in the univariate analysis (OR: 1.24; 95%CI: 0.87–1.86). There was no significant association between Fisher score and unfavorable functional outcomes (mRS > 2) in the univariate analysis (OR: 1.33; 95%CI: 0.92–1.92), nor in the multivariate analysis (OR: 1.37; 95%CI: 0.92–2.05). There was no significant association between modified Fisher scores and unfavorable functional outcomes in the univariate analysis (OR: 1.16; 95%CI: 0.88–1.52). There was also no significant association in the multivariate analysis (OR: 1.18; 95%CI: 0.88–1.57).
Conclusion Only the Fisher scale was associated with mortality. Neither of the two scales was associated with unfavorable functional outcomes (mRS > 2).
Resumo
Objetivo O presente estudo tem como objetivo avaliar e comparar o valor prognóstico dessas duas escalas para predizer mortalidade.
Método Revisamos 172 pacientes com hemorragia subaracnóidea aneurismática, acompanhados por 6 meses. As escalas de Fisher e modificada de Fisher foram avaliadas para a previsão de mortalidade usando regressões logísticas.
Resultados A escala de Fisher foi associada à mortalidade (odds ratio [OR]: 2; intervalo de confiança [IC] 95%: 1.09–4.05) na análise multivariada. A escala Fisher modificada não foi associada à mortalidade na análise multivariada (OR: 1.39; IC95%: 0.9–2.29), nem na análise univariada (OR: 1.24; IC95%: 0.87–1.86). Não houve associação significativa entre o escore de Fisher e resultados funcionais desfavoráveis (mRS > 2) na análise univariada (OR: 1.33; IC95%: 0.92–1.92), nem na análise multivariada (OR: 1.37; IC95%: 0.92–2.05). Não houve associação significativa entre os escores modificados de Fisher e resultados funcionais desfavoráveis na análise univariada (OR: 1.16; IC95%: 0.88–1.52). Também não houve associação significativa na análise multivariada (OR: 1.18; IC95%: 0.88–1.57).
Conclusão Apenas a escala de Fisher foi associada à mortalidade. Nenhuma das duas escalas foi associada a resultados funcionais desfavoráveis (mRS > 2).
Palavras-chave
escala fisher - escala fisher modificada - hemorragia subaracnóidea - aneurismas intracranianos - prognósticoEthical Standards
The present research project was approved by the Ethics and Research Committee of the Hospital das Clínicas of FMUSP. Online registration CAPPesq: 15226 approved 06/20/2016. Approved on the Brazil platform CAAE number: 61719416.6.0000.0068
Disclosure
The authors have no personal, financial, or institutional interest in any of the drugs, materials, or devices described in the present article.
Originality
I, Nícollas Nunes Rabelo, certify that this manuscript is a unique submission and is not being considered for publication with any other source in any medium.
Publication History
Received: 14 April 2023
Accepted: 05 July 2023
Article published online:
27 October 2023
© 2023. Sociedade Brasileira de Neurocirurgia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)
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