Multivariate Analysis Of Prognostic Factors Affecting Surgical Outcome In Patients With Middle Cerebral Artery Aneurysms

Objective:To investigate multiple influence factors on the prognosis after middle cerebral artery aneurysms(MCAA)surgery,and to provide theoretical reference for improving the curative efficacy of middle cerebral artery aneurysms.Method:A total of 260 MCAA subjects who received craniotomy at the affiliated hospital of Qingdao University from 1996 to 2015 were recruited in this study with their clinical information and prognosis condition.GOS scoring was utilized as assessment criteria,and13 factors possibly influencing surgical treatment were included in regression analysis in order to clarify the impact on prognosis.The factors,namely gender,age,subarachnoid hemorrhage times,Hunt-Hess grading,preoperative mental status,aneurysm side,aneurysm size,aneurysm site,aneurysm alignment,operation timing,rupture status,SAH features by CT,postoperative complication,were set as independent variables with curative efficacy as dependent variable,and other factors related to curative efficacy were determined and assigned.The relations between single factor and prognosis were analyzed,which was whether the determined independent variable had impact on the prognosis.Non-parametric statistics with variety rank-sum test was applied to investigate the effect of determined independent variables on prognosis,and statistical significance was obtained when P <0.05.On the contrary,do not pass the test.In the second step,the binary logistic regression model is established.On the basis of the first step,the independent variables are selected and the four cases are divided into two categories.The first level is the first category,That the prognosis of the prognosis is good,the second,third and fourth as the second category,said the prognosis is poor,that treatment that poor prognosis,which were utilized to establish the binary-logistic regression model.SPSS17.0 was applied to the analysis and calculation,in order to discover the factors in prognosis with obvious statistical significance.Result:Via single factor analysis,subarachnoid hemorrhage times,Hung-Hess grading,preoperative mental status,SAH features by CT,postoperative complication had influence on postoperative prognosis to different extent,which were the risk factors of obvious statistical significance.Then binary-logistic step-wise regression was used to variable screening,and the result indicated Hunt-Hess grading and postoperative complications were the most significant risk factor for unfavorable prognosis in MCAA patients.No statistical significance was observed between the curative efficacy in MCAA patients with clipping surgery and gender,age,aneurysm side,aneurysm size,aneurysm site,aneurysm alignment,operation timing,rupture status,respectively.Conclusion:Postoperative complications and Hunt-Hess grading were the most significant risk factor influencing postoperative prognosis in MCAA patients.By analyzing risk factors for middle cerebral aneurysms in patients with subarachnoid hemorrhage times,Hung-Hess grading,preoperative mental status,SAH features by CT,postoperative complication comprehensively and systematically,the prognosis condition after MCAA was basically evaluated.To elevate the accuracy in prognosis prediction and to discover the breakthrough point for improving prognosis,risk factors were further avoided and controlled.Therapeutic approaches were improved and measures were taken,in order to provide reference for further better treatment and to improve clinical prognosis.