Abstract:
OBJECT:Decision tree analysis highlights patient subgroups and critical values in variables assessed. Importantly, the results are visually informative and often present clear clinical interpretation about risk factors faced by patients in these subgroups. The aim of this prospective study was to compare results of logistic regression with those of decision tree analysis of an observational, head-injury data set, including a wide range of secondary insults and 12-month outcomes. METHODS:One hundred twenty-four adult head-injured patients were studied during their stay in an intensive care unit by using a computerized data collection system. Verified values falling outside threshold limits were analyzed according to insult grade and duration with the aid of logistic regression. A decision tree was automatically produced from root node to target classes (Glasgow Outcome Scale [GOS] score). Among 69 patients, in whom eight insult categories could be assessed, outcome at 12 months was analyzed using logistic regression to determine the relative influence of patient age, admission Glasgow Coma Scale score, Injury Severity Score (ISS), pupillary response on admission, and insult duration. The most significant predictors of mortality in this patient set were duration of hypotensive, pyrexic, and hypoxemic insults. When good and poor outcomes were compared, hypotensive insults and pupillary response on admission were significant. Using decision tree analysis, the authors found that hypotension and low cerebral perfusion pressure (CPP) are the best predictors of death, with a 9.2% improvement in predictive accuracy (PA) over that obtained by simply predicting the largest outcome category as the outcome for each patient. Hypotension was a significant predictor of poor outcome (GOS Score 1-3). Low CPP, patient age, hypocarbia, and pupillary response were also good predictors of outcome (good/poor), with a 5.1% improvement in PA. In certain subgroups of patients pyrexia was a predictor of good outcome. CONCLUSIONS:Decision tree analysis confirmed some of the results of logistic regression and challenged others. This investigation shows that there is knowledge to be gained from analyzing observational data with the aid of decision tree analysis.
journal_name
J Neurosurgjournal_title
Journal of neurosurgeryauthors
Andrews PJ,Sleeman DH,Statham PF,McQuatt A,Corruble V,Jones PA,Howells TP,Macmillan CSdoi
10.3171/jns.2002.97.2.0326subject
Has Abstractpub_date
2002-08-01 00:00:00pages
326-36issue
2eissn
0022-3085issn
1933-0693journal_volume
97pub_type
杂志文章abstract:OBJECT:Chronic subdural hematomas (CSDHs) recur in 7 to 18% of cases. The present study was conducted to determine whether serum or lesion concentrations of coagulofibrinolytic and angiogenic factors, which have been reported to be potential markers of CSDH development, might predict such recurrences. METHODS:Sixty co...
journal_title:Journal of neurosurgery
pub_type: 临床试验,杂志文章
doi:10.3171/jns.2006.104.1.79
更新日期:2006-01-01 00:00:00
abstract:OBJECT:Brainstem hemangioblastomas are frequently encountered in patients with von Hippel-Lindau (VHL) disease. These tumors can cause significant morbidity, and their optimal management has not been defined. To better define the outcome and management of these tumors, the authors analyzed the long-term results in pati...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2010.9.JNS10839
更新日期:2011-05-01 00:00:00
abstract::Two patients with fusiform aneurysms and at least one previous subarachnoid hemorrhage were treated by excision of the aneurysms and reconstruction of the arteries. The first case presented with two fusiform aneurysms, the larger of which involved the angular and the smaller one the temporal branch of the left middle ...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1978.49.2.0272
更新日期:1978-08-01 00:00:00
abstract:OBJECTIVE:It is well known that larger aneurysm size is a risk factor for poor outcome after surgical treatment of unruptured saccular intracranial aneurysms (USIAs). However, the authors have occasionally observed poor outcome in the surgical treatment of small USIAs and hypothesized that size ratio has a negative imp...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2018.4.JNS173221
更新日期:2018-09-21 00:00:00
abstract::The neurosurgical management of intrinsic brain tumors and brain metastases mandates maximum resection with preservation of functional cortex. There have been previous reports on the use of cortical somatosensory evoked potentials (SSEPs) for localization of functional cortex prior to resection. The identification of ...
journal_title:Journal of neurosurgery
pub_type: 杂志文章,评审
doi:10.3171/jns.2002.97.3.0709
更新日期:2002-09-01 00:00:00
abstract::OBJECTIVE Over the last half century, there have been isolated case reports of purely arterial malformations. In this study, the authors report a consecutive series of patients with pure arterial malformations, emphasizing the clinical and radiological features of these lesions. METHODS Pure arterial malformations wer...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2017.2.JNS1744
更新日期:2018-07-01 00:00:00
abstract::In clinical follow-up studies after radiosurgery, imaging modalities such as computerized tomography (CT) and magnetic resonance (MR) imaging are used. Accurate determination of the residual lesion volume is necessary for realistic assessment of the effects of treatment. Usually, the diameters rather than the volume o...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.2000.93.supplement
更新日期:2000-12-01 00:00:00
abstract::A technique is described for using a clip-suture to expedite handling of the divided sympathetic chain in a deep, small upper-thoracic exposure. No late failures were experienced in 23 patients with hyperhydrosis surgically treated using this technique. ...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1994.81.3.0482
更新日期:1994-09-01 00:00:00
abstract::Intravascular papillary endothelial hyperplasia (IPEH), commonly known as Masson's tumor, is a benign lesion that manifests as an excessive proliferation of endothelial cells within a vessel wall. IPEH is extremely rare in the brain, with only 36 intracranial cases previously described in the literature. It is commonl...
journal_title:Journal of neurosurgery
pub_type:
doi:10.3171/2019.8.JNS191767
更新日期:2019-11-01 00:00:00
abstract::The authors investigated the outcome of stereotactic biopsy and radiotherapy in 35 consecutive adult patients with nonanaplastic, nonpilocytic astrocytomas who were diagnosed between 1982 and 1992. The median patient age at presentation was 32 years. All received fractionated external-beam radiation therapy (median do...
journal_title:Journal of neurosurgery
pub_type: 临床试验,杂志文章
doi:10.3171/jns.1995.82.4.0523
更新日期:1995-04-01 00:00:00
abstract::OBJECTIVE Patients with poor-grade aneurysmal subarachnoid hemorrhage (aSAH) (World Federation of Neurosurgical Societies Grade IV or V) are often considered for decompressive craniectomy (DC) as a rescue therapy for refractory intracranial hypertension. The authors performed a systematic review and meta-analysis to a...
journal_title:Journal of neurosurgery
pub_type: 杂志文章,meta分析
doi:10.3171/2016.9.JNS161383
更新日期:2017-12-01 00:00:00
abstract::Thirty-eight patients underwent transsphenoidal microsurgical treatment of non-neoplastic intrasellar cysts: 36 had cyst drainage and biopsy of the cyst wall, and in two the cyst was totally removed. Surgical morbidity was 8%. The mean follow-up time was 46.3 months; 100% patient follow-up evaluation was achieved. Six...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1984.60.1.0008
更新日期:1984-01-01 00:00:00
abstract::OBJECT Spontaneous intracranial hypotension is an increasingly recognized cause of headaches. Pituitary enlargement and brain sagging are common findings on MRI in patients with this disorder. The authors therefore investigated pituitary function in patients with spontaneous intracranial hypotension. METHODS Pituitary...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2014.9.JNS132687
更新日期:2015-05-01 00:00:00
abstract:OBJECT:Prognostic factors for outcome after aneurysmal subarachnoid hemorrhage (SAH) include the clinical and pathological characteristics of the patient and hemorrhage as well as some aspects of treatment. Because treatment can vary between countries and continents, the authors used a large database of patients with S...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2008.10.JNS08184
更新日期:2009-07-01 00:00:00
abstract::This series of 228 patients with infantile non-neoplastic hydrocephalus who received either a ventriculoatrial (VA) or a ventriculoperitoneal (VP) shunt before 2 years of age was followed for an average of 7 years, and the results with the two types of shunt were compared. Mortality and infection rates were similar fo...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1979.50.2.0179
更新日期:1979-02-01 00:00:00
abstract:OBJECT:It has been demonstrated that growth of cerebral meningiomas found in humans is controlled by a variety of factors, including growth factors, aminergic agents, neuropeptides, and steroids. To further our knowledge of this process, the authors investigated the presence and function of the cytokines leukemia inhib...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1998.88.3.0541
更新日期:1998-03-01 00:00:00
abstract:OBJECT:Hospital readmission within 30 days of discharge is a major contributor to the high cost of health care in the US and is also a major indicator of patient care quality. The purpose of this study was to investigate the incidence, causes, and predictors of 30-day readmission following craniotomy for malignant supr...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/2014.1.JNS131264
更新日期:2014-05-01 00:00:00
abstract::The authors present a technique involving placement of a catheter in the third ventricle in shunt systems for hydrocephalus, in order to avoid obstruction of the proximal catheter by particles of chorioid plexus. They emphasize the simplicity of the technique, lack of morbidity, and the good results they have obtained...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1975.42.1.0104
更新日期:1975-01-01 00:00:00
abstract::Methyl-2-cyanoacrylate was used to mechanically immobilize the coronal suture unilaterally in a series of New Zealand white rabbits at varying ages. The animals were separated into groups; some were sacrificed at 30 day and some at 60 days postoperatively. Amalgam markers were placed in the parietal and frontal bones ...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1980.53.6.0794
更新日期:1980-12-01 00:00:00
abstract::The effect of suppression of postischemic reactive hyperemia on the blood-brain barrier (BBB) and ischemic brain edema after temporary focal cerebral ischemia was studied in cats under ketamine and alpha-chloralose anesthesia. Regional cerebral blood flow (rCBF) was measured by a thermal diffusion method and a hydroge...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1989.70.1.0073
更新日期:1989-01-01 00:00:00
abstract::The authors present the case history of a patient in whom the peritoneal catheter of a ventriculoperitoneal shunt system caused ureter obstruction. This is a rare complication of such a shunt procedure, and the patient's symptoms were relieved by shortening the peritoneal catheter. ...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1983.59.3.0542
更新日期:1983-09-01 00:00:00
abstract::A computer-based system has been developed for the integration and display of computerized tomography (CT) image data in the operating microscope in the correct perspective without requiring a stereotaxic frame. Spatial registration of the CT image data is accomplished by determination of the position of the operating...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1986.65.4.0545
更新日期:1986-10-01 00:00:00
abstract::Articular cysts of the atlantoaxial joint are infrequently described and probably an underreported cause of upper cervical spinal cord compression. The authors report on two patients with cysts located posteriorly of the dens in whom a C-1 and partial C-2 hemilaminectomy with subtotal resection of the cyst provided ad...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/spi.2001.95.1.0111
更新日期:2001-07-01 00:00:00
abstract::Massive osteolysis is a type of idiopathic osteolysis in which there is spontaneous onset of bone resorption. Almost any bone in the body can be affected. The authors present the case of a 62-year-old man diagnosed with massive osteolysis of the occipital bone and the upper two cervical vertebrae. Despite extensive pn...
journal_title:Journal of neurosurgery
pub_type: 杂志文章,评审
doi:10.3171/jns.1997.87.5.0773
更新日期:1997-11-01 00:00:00
abstract::A 6-year-old girl with a history of a nondisplaced skull fracture diagnosed with computerized tomography (CT) scanning 3 years previously presented with a 6-week history of headaches and decreased use of her right side. On admission CT scans, a large cystic mass was identified in the left frontal lobe region of the br...
journal_title:Journal of neurosurgery
pub_type: 杂志文章,评审
doi:10.3171/jns.2001.95.6.1040
更新日期:2001-12-01 00:00:00
abstract::Magnetic resonance (MR) angiography offers a safe, noninvasive alternative to conventional angiography in patients with suspected carotid stenosis; however, it tends to overestimate the severity of stenosis. Loss of the MR signal with a resulting flow gap is a frequent finding in cases of high-grade stenosis. The auth...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1996.85.3.0384
更新日期:1996-09-01 00:00:00
abstract:OBJECT:The treatment of solitary vestibular schwannomas by performing Gamma Knife surgery is well established. It has been reported that decreasing the surface dose reduces patient morbidity, especially facial weakness and numbness. The authors of this retrospective study examine patient data from a single center to de...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/sup.2006.105.7.154
更新日期:2006-12-01 00:00:00
abstract::In this paper the authors present the first evidence that meningiomas respond to treatment with hydroxyurea. Hydroxyurea was administered as an adjunct chemotherapeutic treatment in patients with recurrent and unresectable meningiomas. Hydroxyurea was used because experimental data demonstrated that it inhibits growth...
journal_title:Journal of neurosurgery
pub_type: 临床试验,杂志文章
doi:10.3171/jns.1997.86.5.0840
更新日期:1997-05-01 00:00:00
abstract::Excision is the treatment of choice in cases of sacral chordoma. Local recurrences, however, have often been observed even after total en bloc resection. The authors assessed outcomes in four cases of tumor recurrence in patients who underwent total en bloc S2-3 resection for sacral chordomas that were located below S...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/spi.2002.97.1.0098
更新日期:2002-07-01 00:00:00
abstract::Clinical studies with transcranial Doppler suggest that the pulsatility of the flow velocity (FV) waveform increases when the distal cerebrovascular resistance (CVR) increases. To clarify this relationship, the authors studied animal models in which the resistance may be decreased in a controlled manner by an increase...
journal_title:Journal of neurosurgery
pub_type: 杂志文章
doi:10.3171/jns.1996.84.1.0079
更新日期:1996-01-01 00:00:00