Ottawa Subarachnoid Hemorrhage (SAH) Rule

Ottawa Subarachnoid Hemorrhage (SAH) Rule
Rule Inclusion Criteria
[select name="QA" value="yes=0|NO=10"] <-- Age 15 years or over
[select name="QB" value="yes=0|NO=10"] <-- New, severe nontraumatic headache
[select name="QC" value="yes=0|NO=10"] <-- Headache reached maximum intensity within 1 hour
[select name="QD" value="no=0|YES=10"] <-- Neurologic deficits
[select name="QE" value="no=0|YES=10"] <-- Previous aneurysms
[select name="QF" value="no=0|YES=10"] <-- History of recurrent headaches (3 or more episodes in the last 6 or more months)
High Risk Variables
[select name="Q1" value="no=0|YES=1"] <-- Age 40 years or over
[select name="Q2" value="no=0|YES=1"] <-- Neck pain or stiffness
[select name="Q3" value="no=0|YES=1"] <-- Witnessed loss of consciousness
[select name="Q4" value="no=0|YES=1"] <-- Onset during exertion
[select name="Q5" value="no=0|YES=1"] <-- Thunderclap headache (instantly peaking pain)
[select name="Q6" value="no=0|YES=1"] <-- Limited neck flexion on examination

Interpretation --> [calc memo="Interpretation" value="score=(QA)+(QB)+(QC)+(QD)+(QE)+(QF)+(Q1)+(Q2)+(Q3)+(Q4)+(Q5)+(Q6);score>9?'Does not meet rule inclusion criteria.  Ottawa SAH Rule may not be used.':score>0?'Meets Inclusion Criteria AND Has High Risk Variables.  Further investigation for Subarachnoid Hemorrhage is recommended per Ottawa SAH Rule':'Meets Inclusion Criteria AND Has No High Risk Variables.  Further investigation for Subarachnoid Hemorrhage may not be necessary.'"]
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reference:  
[link url="//jama.jamanetwork.com/article.aspx?articleid=1741823#.UkQq2izx9H0" memo="#1"] Perry JJ, Stiell IG, Sivilotti MA, et al. Clinical Decision Rules to Rule Out Subarachnoid Hemorrhage for Acute Headache. JAMA. 2013;310(12):1248-1255.
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