Vasospasm Decision Support System

Patients who suffer from subarachnoid hemorrhage (bleeding in the subarachnoid layer of the outer section of the brain) are treated with surgery and are kept in the neurologic ICU for fourteen days post-surgery for monitoring. These patients are at increased risk for cerebral vasospasm, a rapid constriction of the blood vessels in the brain which cases reduced blood flow and, if left untreated, results in ischemia, stroke, or death. Currently, definitive diagnosis of vasospasm requires the patient to undergo an angiogram, which is invasive, expensive, and carries some risk to the patient. Because angiogram is only used when the level of suspicion for vasospam is high, early detection by caregivers is vita. Caregivers rely on a combination of various features, such as vital signs and lab values, to provide evidence a patient is experiencing vasospasm. They use these features to assess a patient's risk for vasospasm.

We utilized these features to create a CDSS to aid doctors in diagnosing vasospasm in SAH patients. The goal was to implement the three pronged approach outlined above to create a comprehensive risk assessment for vasospasm represented by three numerical scores, as well as designing the system to provide supporting evidence and information to allow caregivers to further explore the cause of the risk perceived by the system. In this way, we aimed to provide a tool that will allow caregivers to customize care for patients to reduce the number of deaths due to vasospasm.