A dynamic online nomogram for predicting death in hospital after aneurysmal subarachnoid hemorrhage 

Abstract Background This study aimed to confirm the validity of the multiplication of neutrophils and monocytes (MNM) and a novel dynamic nomogram for predicting in-hospital death in patients with aneurysmal subarachnoid hemorrhage (aSAH).Methods An analysis of 986 patients who underwent endovascular coiling for aSAH was conducted retrospectively. Univariate and multivariate logistic regression analysis identified independent risk factors associated with in-hospital death. A dynamic nomogram of in-hospital deaths was introduced in the development cohort and published online in the form of a simple calculator. Receiver operating characteristic analysis, calibration analysis, and decision curve analysis were performed to estimate the nomogram for predicting the in-hospital death from the external validation cohort.Results 72/687 patients (10.5%) in the development cohort and 31/299 (10.4%) in the validation cohort died. Based on univariate and multivariate regression analyses, MNM was associated with in-hospital death. A novel nomogram showed excellent predictive power for in-hospital death in the development cohort. The calibration curves indicated that the nomogram has reliable consistency and calibration degree. The net benefit of the nomogram was better than that of the basic model with threshold probabilities between 10% and 90%. In the validation cohort, the MNM and nomogram also exhibited good predictive values for in-hospital death.Conclusions MNM is a new indicator used to predict in-hospital death of patients with aSAH. A dynamic nomogram is an effective tool for predicting in-hospital death in aSAH patients.