Supplementary file 1_Inflammation, coagulation, and nutritional reserves refine 90-day prognostic stratification after ruptured intracranial aneurysm repair.docx

Existing prognostic models primarily rely on neurological and radiological severity and may overlook systemic biological alterations.</p>Objective<p>To evaluate whether integrating systemic immune-inflammation index (SII), D-dimer, and prognostic nutritional index (PNI) with clinical-radiological factors improves prediction of 90-day unfavorable neurological recovery after aneurysm repair.</p>Methods<p>This single-center retrospective cohort study included 209 patients with aneurysmal subarachnoid hemorrhage undergoing clipping or coiling between January 2023 and December 2025.

The primary outcome was unfavorable 90-day functional recovery (modified Rankin Scale 3–6). Admission biomarkers were analyzed using multivariable logistic regression. An admission model and an updated in-hospital model incorporating delayed cerebral ischemia (DCI) were developed and evaluated using discrimination, calibration, decision curve analysis, and bootstrap validation.</p>Results<p>Among 209 patients, 66 (31.6%) had unfavorable outcomes.