Multivariate Study On The Prognosis Of Reptured Anterior Communicating Artery Aneurysm For Neurosurgical Clipping

Objective:To explore the risk factors affecting the prognosis of anterior communicating artery aneurysm for neurosurgical clipping,in order to improve the clinical operation and the prognosis of patients.Methods:Retrospective analysis of the clinical data of 114 patients with anterior communicating artery aneurysm ruptured and bleeding who underwent neurosurgery from the First Hospital of Shanxi Medical University from February 2014 to September 2018.The Glasgow Outcome Scale(GOS)was used at the time of discharge.The prognosis of patients was divided into two groups: poor prognosis and good prognosis.Univariate and multivariate logistic regression models were used to assess 13 factors that may affect prognosis [patient gender,age,preoperative comorbidities(hypertension,diabetes,coronary sclerosing heart disease,hyperlipidemia),preoperatively Hemorrhage,SAH modified Fisher classification,aneurysm characteristics(specific size,firing site,pointing),Hunt-Hess classification,timing of surgery,surgical approach,intraoperative aneurysm rupture,intraoperative resection,or intraoperative Cerebral vasospasm and postoperative complications(cerebral infarction,hydrocephalus,cerebral edema,water-electrolyte disorders,intracranial infection,pulmonary infection)],statistically screened for affecting anterior communicating aneurysm clipping with GOS score as a dependent variable Independent risk factors for prognosis.Results:(1)Univariate analysis included 13 factors including gender,age,preoperative complications(hypertension,coronary heart disease,hyperlipidemia),aneurysm characteristics(specific location,size,orientation),surgical approach Surgical timing,whether the aneurysm was ruptured during operation,whether the resection was performed during surgery,and postoperative complications(brain edema,pulmonary infection,water-electrolyte disorder,intracranial infection)had no significant effect on prognosis(P>0.05).Preoperative bleeding,diabetes,SAH modified Fisher classification,Hunt-Hess classification,intraoperative cerebral vasospasm and postoperative complications(cerebral infarction,hydrocephalus)were associated with prognosis(P < 0.05).(2)Multivariate analysis of factors that are significant for univariate analysis suggests preoperative rebleeding,SAH modified Fisher high grade,Hunt-Hess high grade,and postoperative cerebral infarction are independent risk factors for poor prognosis.Conclusion:Preoperative bleeding,SAH modified Fisher high grade,Hunt-Hess high grade,postoperative cerebral infarction is an independent risk factor for poor prognosis,timing of surgery,postoperative complications(water and electrolyte disorders and lung infections,etc.)on prognosis Further prospective studies are needed to confirm that individualized treatment options to prevent postoperative complications can significantly improve patient outcomes.