2026-10-11T07:02:45Z https://api.figshare.com/v2/oai

oai:figshare.com:article/33827641 2026-09-16T04:31:06Z category_374 portal_316 item_type_3 month_year_09_2026

Supplementary file 1_Inflammation, coagulation, and nutritional reserves refine 90-day prognostic stratification after ruptured intracranial aneurysm repair.docx Jian Li (41607) Zhen Wang (72451) Hongwen Li (2611516) Xinyu Yang (197010) Clinical and Sports Nutrition aneurysmal subarachnoid hemorrhage d-dimer neurological recovery prognostic nutritional index retrospective study ruptured intracranial aneurysm systemic immune-inflammation index Background<p>Ruptured intracranial aneurysm is a major cause of neurological disability. Existing prognostic models primarily rely on neurological and radiological severity and may overlook systemic biological alterations.</p>Objective<p>To evaluate whether integrating systemic immune-inflammation index (SII), D-dimer, and prognostic nutritional index (PNI) with clinical-radiological factors improves prediction of 90-day unfavorable neurological recovery after aneurysm repair.</p>Methods<p>This single-center retrospective cohort study included 209 patients with aneurysmal subarachnoid hemorrhage undergoing clipping or coiling between January 2023 and December 2025. The primary outcome was unfavorable 90-day functional recovery (modified Rankin Scale 3–6). Admission biomarkers were analyzed using multivariable logistic regression. An admission model and an updated in-hospital model incorporating delayed cerebral ischemia (DCI) were developed and evaluated using discrimination, calibration, decision curve analysis, and bootstrap validation.</p>Results<p>Among 209 patients, 66 (31.6%) had unfavorable outcomes. Independent predictors included Hunt–Hess grade IV–V (aOR 3.85, 95% CI 1.84–8.06), modified Fisher grade 3–4 (aOR 2.76, 95% CI 1.28–5.95), acute hydrocephalus (aOR 2.62, 95% CI 1.25–5.48), higher SII (aOR 1.32 per 500-unit increase), higher D-dimer (aOR 1.22 per 1 mg/L increase), and lower PNI (aOR 0.68 per 5-point increase). The admission model achieved an AUC of 0.82 (95% CI 0.76–0.88), while the updated model incorporating DCI improved the AUC to 0.86 (95% CI 0.80–0.91), with an optimism-corrected AUC of 0.83 after bootstrap validation.</p>Conclusion<p>An integrated model combining inflammatory, coagulation, nutritional, and clinical-radiological factors improved risk stratification after ruptured intracranial aneurysm repair. Incorporation of DCI provided additional prognostic value, although external validation is needed.</p> 2026-09-16T04:31:06Z Dataset Dataset 10.3389/fnut.2026.1918951.s001 https://figshare.com/articles/dataset/Supplementary_file_1_Inflammation_coagulation_and_nutritional_reserves_refine_90-day_prognostic_stratification_after_ruptured_intracranial_aneurysm_repair_docx/33827641 CC BY 4.0