This multicentre prospective cohort study aimed to compare the accuracy of the PAASH, WFNS, and Hunt and Hess (H&H) scales in predicting the outcomes of adult patients with aneurysmal SAH presented to three central hospitals in Hanoi, Vietnam, from August 2019 to June 2021. Of 415 eligible patients, 32.0% had a 90-day poor outcome, defined as an mRS score of 4 (moderately severe disability) to 6 (death). The PAASH, WFNS and H&H scales all have good discriminatory abilities for predicting the 90-day poor outcome. There were significant differences in the 90-day mean mRS scores between grades I and II (p = 0.001) and grades II and III (p = 0.001) of the PAASH scale, between grades IV and V (p = 0.026) of the WFNS scale, and between grades IV and V (p < 0.001) of the H&H scale. In contrast to a WFNS grade of IV-V and an H&H grade of IV-V, a PAASH grade of III-V was an independent predictor of the 90-day poor outcome. Because of the more clearly significant difference between the outcomes of the adjacent grades and the more strong effect size for predicting poor outcomes, the PAASH scale was preferable to the WFNS and H&H scales.

Center for Critical Care Medicine Bach Mai Hospital Hanoi Vietnam

Center for Emergency Medicine Bach Mai Hospital 78 Giai Phong Road Phuong Mai Ward Dong Da District Hanoi 100000 Vietnam

Department of Emergency and Critical Care Medicine Hanoi Medical University Hanoi Vietnam

Department of Health Organization and Management Faculty of Public Health Thai Binh University of Medicine and Pharmacy Thai Binh Vietnam

Department of Neurosurgery 2 Neurosurgery Center Vietnam Germany Friendship Hospital Hanoi Vietnam

Department of Neurosurgery Bach Mai Hospital Hanoi Vietnam

Department of Nutrition and Food Safety Faculty of Public Health Thai Binh University of Medicine and Pharmacy Thai Binh Vietnam

Department of Radiology Hanoi Medical University Hanoi Vietnam

Department of Surgery Hanoi Medical University Hanoi Vietnam

Emergency and Critical Care Department Hanoi Medical University Hospital Hanoi Medical University Hanoi Vietnam

Emergency Department Agriculture General Hospital Hanoi Vietnam

Emergency Department Vietnam Czechoslovakia Friendship Hospital Hai Phong Vietnam

Faculty of Medicine University of Medicine and Pharmacy Vietnam National University Hanoi Vietnam

Radiology Centre Bach Mai Hospital Hanoi Vietnam

Stroke Center Bach Mai Hospital Hanoi Vietnam

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Validation of the accuracy of the modified World Federation of Neurosurgical Societies subarachnoid hemorrhage grading scale for predicting the outcomes of patients with aneurysmal subarachnoid hemorrhage