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Some patients with WFNS grade V aSAH have had good outcomes after aggressive treatment; however, outcome predictions based on routine examinations and findings obtained at admission are yet to be reported. This study aimed to develop a decision tree model for predicting outcomes of patients with WFNS grade V aSAH to aid decision-making for treatment strategy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Method<\/jats:title>\n                    <jats:p>A multicenter study with retrospective and prospective data collected from 201 (derivation cohort) and 26 (validation cohort) patients with WFNS grade V aSAH, respectively, was conducted. Clinical outcomes were divided into good (Modified Rankin Scale [mRS] score at the time of discharge: 0\u20132) and poor (mRS score: 3\u20136) outcomes. A decision tree model was developed for the derivation cohort using the classification and regression tree method with clinical data including laboratory findings; it was named OPAS-V (Outcome Prediction in Aneurysmal Subarachnoid hemorrhage with WFNS grade V). The performance of the model was evaluated by area under the curve (AUC) and overall accuracy in both cohorts.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>OPAS-V comprised 3 metrics; the percentage of lymphocytes (&lt;\u200949.9% or not), age (&gt;\u200950 yrs or not), and glucose to potassium ratio (\u2265\u20093.2 or not). The model achieved an AUC of 0.828 (95% confidence interval: 0.712\u20130.944) and overall accuracy of 0.930. Moreover, the model performed well in the validation cohort with an AUC of 0.727 (95% confidence interval: 0.441\u20131) and overall accuracy of 0.885.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This study developed the first decision tree model for predicting outcomes of patients with WFNS grade V aSAH, based on simple findings obtained at admission. This may aid clinicians in determining treatment strategies for severe conditions such as WFNS grade V aSAH.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00701-025-06611-7","type":"journal-article","created":{"date-parts":[[2025,7,24]],"date-time":"2025-07-24T01:51:19Z","timestamp":1753321879000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Outcome prediction in aneurysmal subarachnoid hemorrhage with world federation of neurological societies grade V (OPAS-V)"],"prefix":"10.1007","volume":"167","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5734-9620","authenticated-orcid":false,"given":"Shuhei","family":"Yamada","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takeo","family":"Nishida","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tomofumi","family":"Takenaka","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiroki","family":"Yamazaki","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ryota","family":"Nakagawa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masatoshi","family":"Takagaki","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoshihiro","family":"Yano","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hajime","family":"Nakamura","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shingo","family":"Toyota","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Toshiyuki","family":"Fujinaka","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takuyu","family":"Taki","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Toshiaki","family":"Fujita","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haruhiko","family":"Kishima","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,7,24]]},"reference":[{"issue":"8","key":"6611_CR1","doi-asserted-by":"publisher","first-page":"390","DOI":"10.2176\/nmc.oa.2020-0052","volume":"60","author":"K Ariyada","year":"2020","unstructured":"Ariyada K, Ohida T, Shibahashi K, Hoda H, Hanakawa K, Murao M (2020) Long-term functional outcomes for world federation of neurosurgical societies grade v aneurysmal subarachnoid hemorrhage after active treatment. 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