{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,26]],"date-time":"2026-06-26T06:45:27Z","timestamp":1782456327478,"version":"3.54.5"},"reference-count":35,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2021,7,28]],"date-time":"2021-07-28T00:00:00Z","timestamp":1627430400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100012226","name":"Fundamental Research Funds for the Central Universities","doi-asserted-by":"publisher","award":["2019QNA7038"],"award-info":[{"award-number":["2019QNA7038"]}],"id":[{"id":"10.13039\/501100012226","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["81870916"],"award-info":[{"award-number":["81870916"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["81971107"],"award-info":[{"award-number":["81971107"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["CNS Neurosci Ther"],"published-print":{"date-parts":[[2021,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:label\/><jats:p>To the best of our knowledge, this is the largest clinical retrospective study in AN\u2010SAH patients, and is the first time to establish accurate predictive models paired with bleeding pattern.<\/jats:p><\/jats:sec><jats:sec><jats:title>Background<\/jats:title><jats:p>Angiogram\u2010negative subarachnoid hemorrhage (AN\u2010SAH) has a definite incidence of delayed cerebral ischemia (DCI) and poor clinical outcomes. The purpose is to screen independent factors and establish a nomogram to guide the clinical therapy and assess post\u2010discharge prognosis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We identified 273 consecutive patients referred to our institute from 2013 to 2018 for AN\u2010SAH. A nomogram to predict poor outcomes was formulated based on the multivariable models of independent risk factors. The accuracy and discrimination of nomograms were determined in training and internal validation cohorts.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The overall poor outcome rates of AN\u2010SAH were 14.3% and 8.7% at 3\u00a0months and 12\u00a0months, respectively. In addition, perimesencephalic AN\u2010SAH (PAN\u2010SAH) presented with a more unfavorable prognosis compared with non\u2010perimesencephalic AN\u2010SAH (NPAN\u2010SAH). The clinical prognosis was associated with the World Federation of Neurosurgical Societies scale (WFNS) (odds ratio, 3.82 [95% CI, 1.15\u201012.67] for 3\u2010month outcome; and odds ratio, 31.69 [95% CI, 3.65\u2010275.43] for 12\u2010month outcome), Subarachnoid hemorrhage Early Brain Edema Score (SEBES) (odds ratio, 10.39 [95% CI, 1.98\u201054.64] for 3\u2010month outcome; odds ratio, 10.01 [95% CI, 1.87\u201053.73] for 12\u2010month outcome), and symptomatic vasospasm (odds ratio, 3.16 [95% CI, 1.03\u20109.70] for 3\u2010month outcome; odds ratio, 5.15 [95% CI, 1.34\u201019.85] for 12\u2010month outcome). The nomogram was constructed based on the above features, which represented great predictive value in clinical outcomes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Symptomatic vasospasm, high WFNS, cerebral edema, and NPAN\u2010SAH after hemorrhage were associated with poor outcome of AN\u2010SAH. The nomogram with WFNS (3\u20105), SEBES (3\u20104), vasospasm, and NPAN\u2010SAH represented a practical approach to provide individualized risk assessment for AN\u2010SAH patients.<\/jats:p><\/jats:sec>","DOI":"10.1111\/cns.13712","type":"journal-article","created":{"date-parts":[[2021,7,28]],"date-time":"2021-07-28T16:57:56Z","timestamp":1627491476000},"page":"1339-1347","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Development of a nomogram for predicting clinical outcome in patients with angiogram\u2010negative subarachnoid hemorrhage"],"prefix":"10.1111","volume":"27","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0007-7724","authenticated-orcid":false,"given":"Anke","family":"Zhang","sequence":"first","affiliation":[{"name":"Department of Neurosurgery The Second Affiliated Hospital School of Medicine Zhejiang University Zhejiang China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zeyu","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery The Second Affiliated Hospital School of Medicine Zhejiang University Zhejiang China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wen\u2010Bo","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery National Clinical Research Center for Child Health The Children's Hospital of Zhejiang University School of Medicine Zhejiang China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaoyu","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery The Second Affiliated Hospital School of Medicine Zhejiang University Zhejiang China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cameron","family":"Lenahan","sequence":"additional","affiliation":[{"name":"Center for Neuroscience Research Loma Linda University School of Medicine Loma Linda CA USA"},{"name":"Burrell College of Osteopathic Medicine Las Cruces NM USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuanjian","family":"Fang","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery The Second Affiliated Hospital School of Medicine Zhejiang University Zhejiang China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yujie","family":"Luo","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery The Second Affiliated Hospital School of Medicine Zhejiang University Zhejiang China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yibo","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery The Second Affiliated Hospital School of Medicine Zhejiang University Zhejiang China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shuhao","family":"Mei","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery The Second Affiliated Hospital School of Medicine Zhejiang University Zhejiang China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8374-136X","authenticated-orcid":false,"given":"Sheng","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery The Second Affiliated Hospital School of Medicine Zhejiang University Zhejiang China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3184-1502","authenticated-orcid":false,"given":"Jianmin","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery The Second Affiliated Hospital School of Medicine Zhejiang University Zhejiang China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2021,7,28]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(16)30668-7"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1093\/neuros\/nyx188"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.wneu.2016.07.019"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.clineuro.2013.02.002"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1155\/2020\/9707238"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.wneu.2018.04.096"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1385\/NCC:2:2:110"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.3171\/jns.1968.28.1.0014"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1097\/00006123-199707000-00029"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1227\/01.NEU.0000218821.34014.1B"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1093\/neuros\/nyx364"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.115.008728"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12028-013-9952-9"},{"key":"e_1_2_11_15_1","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.108.191395"},{"key":"e_1_2_11_16_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12028-011-9605-9"},{"key":"e_1_2_11_17_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00330-020-07242-5"},{"key":"e_1_2_11_18_1","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.108.544700"},{"key":"e_1_2_11_19_1","doi-asserted-by":"publisher","DOI":"10.1080\/26895293.2021.1898052"},{"issue":"1","key":"e_1_2_11_20_1","doi-asserted-by":"crossref","first-page":"185","DOI":"10.4103\/0028-3886.253627","article-title":"Cerebral vasospasm and delayed cerebral ischemia: Review of literature and the management approach","volume":"67","author":"Chugh C","year":"2019","journal-title":"Neurol India"},{"key":"e_1_2_11_21_1","doi-asserted-by":"publisher","DOI":"10.23736\/S0375-9393.20.14820-X"},{"key":"e_1_2_11_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.radonc.2020.11.023"},{"key":"e_1_2_11_23_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41440-020-00558-1"},{"key":"e_1_2_11_24_1","doi-asserted-by":"publisher","DOI":"10.1097\/BSD.0000000000000695"},{"key":"e_1_2_11_25_1","doi-asserted-by":"publisher","DOI":"10.1111\/cns.13222"},{"key":"e_1_2_11_26_1","doi-asserted-by":"publisher","DOI":"10.1177\/0271678X19863021"},{"key":"e_1_2_11_27_1","doi-asserted-by":"publisher","DOI":"10.1177\/0271678X19887052"},{"key":"e_1_2_11_28_1","doi-asserted-by":"publisher","DOI":"10.1111\/cns.13548"},{"key":"e_1_2_11_29_1","doi-asserted-by":"publisher","DOI":"10.1177\/0271678X19841443"},{"key":"e_1_2_11_30_1","doi-asserted-by":"publisher","DOI":"10.1111\/cns.13221"},{"key":"e_1_2_11_31_1","doi-asserted-by":"publisher","DOI":"10.1111\/cns.13199"},{"key":"e_1_2_11_32_1","doi-asserted-by":"publisher","DOI":"10.1155\/2013\/371063"},{"key":"e_1_2_11_33_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00701-012-1383-4"},{"key":"e_1_2_11_34_1","doi-asserted-by":"publisher","DOI":"10.1227\/01.NEU.0000108862.32404.A5"},{"key":"e_1_2_11_35_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra052760"},{"key":"e_1_2_11_36_1","doi-asserted-by":"publisher","DOI":"10.3171\/2019.12.JNS192744"}],"container-title":["CNS Neuroscience &amp; Therapeutics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/cns.13712","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/cns.13712","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/cns.13712","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,9,5]],"date-time":"2024-09-05T07:45:30Z","timestamp":1725522330000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/cns.13712"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,7,28]]},"references-count":35,"journal-issue":{"issue":"11","published-print":{"date-parts":[[2021,11]]}},"alternative-id":["10.1111\/cns.13712"],"URL":"https:\/\/doi.org\/10.1111\/cns.13712","archive":["Portico"],"relation":{},"ISSN":["1755-5930","1755-5949"],"issn-type":[{"value":"1755-5930","type":"print"},{"value":"1755-5949","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,7,28]]},"assertion":[{"value":"2021-04-08","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-07-19","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-07-28","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}