Subphenotyping aneurysmal subarachnoid Hemorrhage using clinical and biological data clustering
Santafé, Manel (Parc Taulí Hospital Universitari. Institut d'Investigació i Innovació Parc Taulí (I3PT))
Quintana, Manuel (Hospital Universitari Vall d'Hebron. Institut de Recerca)
Anna Sánchez (Hospital Universitari Vall d'Hebron. Institut de Recerca)
Gracia, Rosa Maria (Hospital Universitari Vall d'Hebron. Institut de Recerca)
Campos Fernández, Daniel (Hospital Universitari Vall d'Hebron. Institut de Recerca)
Abraira del Fresno, Laura (Hospital Universitari Vall d'Hebron. Institut de Recerca)
Santamarina, E. (Hospital Universitari Vall d'Hebron. Institut de Recerca)

Data:	2025
Resum:	Background: Aneurysmal subarachnoid hemorrhage (aSAH) is an heterogeneous disease with variable outcomes, even among patients with similar clinical and radiological severity. Additional research is needed to better stratify aSAH patients. Objectives: To identify distinct clinical subphenotypes of aSAH, we applied clustering analysis using clinical, radiological, and laboratory data. Methods: We conducted a retrospective cohort study of adult patients with aSAH admitted to the ICU between 2010 and 2021. K-means clustering was applied to standardized demographic, clinical, and laboratory variables collected at admission. Principal component analysis was used for dimensionality reduction and visualization. Additionally, we analyzed whether these clusters were associated with serum biomarkers (S100B, HMGB1, and TLR4) in a subset of patients. Results: The study included 511 patients with aSAH. Two distinct subphenotypes were identified: a High-Risk Cluster (n = 301, 58. 9 %) characterized by severe systemic complications, and higher mortality, and a Low-Risk Cluster (n = 210, 41. 1 %) with less severe symptoms and better outcomes. Serum S100B levels were significantly elevated in the High-Risk Cluster (0. 077 [0. 056-0. 179] vs. 0. 055 [0. 040-0. 079] μg/L, p = 0. 008) and showed moderate discriminatory power (AUC = 0. 72). Conclusions: Clustering analysis revealed two aSAH subphenotypes associated with DCI, mortality and functional. Integrating early clinical and biomarker data could enhance patient stratification.
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Llengua:	Anglès
Document:	Article ; recerca ; Versió acceptada per publicar
Publicat a:	Journal of Critical Care, Vol. 92 (November 2025) , art. 155365, ISSN 1557-8615

DOI: 10.1016/j.jcrc.2025.155365

Disponible a partir de: 2026-11-30 24 p, 995.8 KB

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Documents de recerca > Documents dels grups de recerca de la UAB > Centres i grups de recerca (producció científica) > Ciències de la salut i biociències > Institut d’Investigació i Innovació Parc Taulí (I3PT)
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