| Predicting neurological complications post clipping surgery in unruptured intracranial aneurysms using the NEURO score: a multi-center retrospective cohort study |
|
Yeon Ju Kim1, Ah Ran Oh2, Soo Jeong3, Jungchan Park2, Min-Ju Kim4, Seong-yoon Kim5, Wonhyoung Park6, Jae Sung Ahn6, Chan-Sik Kim1, Ji-Hoon Sim1, Yong-Seok Park1, Seungil Ha1, Joung Uk Kim1 |
1Department of Anaesthesiology and Pain Medicine, Asan Medical Centre, University of Ulsan College of Medicine, Seoul, Republic of Korea
2Department of Anaesthesiology and Pain Medicine, Samsung Medical Centre, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
3Department of Neurology, Hanyang University College of Medicine, Seoul, Republic of Korea
4Department of Clinical Epidemiology and Biostatistics, Asan Medical Centre, University of Ulsan College of Medicine, Seoul, Republic of Korea
5Korea Electronics Technology Institute, Seongnam, Republic of Korea
6Department of Neurological Surgery, Asan Medical Centre, University of Ulsan College of Medicine, Seoul, Republic of Korea |
Corresponding author:
Chan-Sik Kim, Tel: +82-2-3010-0771, Fax: +82-2-3010-6790,
Email: chansik.kim86@gmail.com
Ji-Hoon Sim, Tel: +82-2-3010-0586, Fax: +82-2-3010-6790,
Email: jihoon_sim@amc.seoul.kr
|
Received: 31 December 2024 • Revised: 25 April 2025 • Accepted: 25 April 2025
*Yeon Ju Kim and Ah Ran Oh contributed equally to this study as co-first authors. |
|
|
| Abstract |
Background
Predicting fatal neurological complications after clipping surgery for unruptured intracranial aneurysms (UIAs) is crucial; however, existing scoring systems are limited by narrow consideration of factors. We aimed to develop and validate a comprehensive risk stratification scoring system that incorporates patient-, aneurysm-, and operation-specific variables for predicting postoperative neurological complications in UIA surgeries.
Methods
This multi-center retrospective cohort study was conducted from September 2018 to October 2023. Patients undergoing clipping surgery for UIAs were divided into development and validation sets based on the treating institution. A predictive score for postoperative neurological complications was developed from a multivariate logistic regression analysis. The score, named NEURO, that incorporates variables like previous neurological disease, categorized aneurysm location and size, categorized operation time, and transfusion was validated externally.
Results
The study included 2847 patients, with 1547 and 1300 in the development and validation sets, based on the institution of surgery, respectively. The incidence of neurological complications was 5.7% (88 / 1547) and 5.6% (73 / 1300) in the development and validation sets, respectively. The NEURO score showed good predictive ability with C-statistics of 0.720 (95% CI, 0.667–0.776) in the development set and 0.693 (95% CI, 0.631–0.754) in the validation set, demonstrating good calibration across the predicted probability range.
Conclusions
The NEURO score, integrating multiple perioperative variables, may effectively predict the risk of neurological complications post UIA clipping surgery, aiding in identifying high-risk patients. This tool could enhance clinical decision-making and patient management in neurosurgical practice. |
| Key Words:
Cerebrovascular disorders; Intracranial aneurysm; Multicenter study; Neurosurgery; Postoperative complications; Risk assessment |
|
PDF Links
Full text via DOI
Download Citation
