Analysis Of The Related Factors For Preoperative Rebleeding Of Aneurysmal Subarachnoid Hemorrhage

Objective:The purpose of this article is to summarize the incidence of preoperative rebleeding in patients with aSAH.Surgical intervention includes surgical clipping and endovascular interventional treatment.The risk factors that may be involved in rebleeding will be discussed.Better prevention and treatment of rebleeding before surgerySubjects and methods:This experiment mainly collected from July 2018-March 2021,the First Affiliated Hospital Of Dalian Medical University of aSAH patients admitted in a division of neurosurgery clinical information,a total of treated patients with 305 cases,preoperative bleeding again whether to happen again,will eventually collected all cases were divided into bleeding group(56 cases)and rebleeding group(249 cases)。Use univariate analysis to conduct in-depth discussion,analyze the different manifestations of the two groups of patients,including general conditions,clinical manifestations and other variables.With Spearman correlation analysis method,the relationship between clinical indicators and rebleeding was taken as the research object,and then multivariate Logistic regression analysis was carried out to determine the risk factors for preoperative rebleeding.Result:(1)According to the analysis,a total of 56 aSAH patients suffered from preoperative rebleeding,and the incidence of rebleeding was calculated to be 18.4%(56/305)(2)Univariate analysis,gender(P=0.583),history of smoking(P=0.612),alcohol abuse(P=0.974),hypertension(P=0.612),diabetes(P=0.090),history of heart disease(P=0.636).Epileptic seizure(P<0.001);Hematoma formation(P<0.001);Sentinel headache(P<0.001);Aneurysm location(P=0.882).(3)Using the rank sum test,patients with Hunt-Hess grade 2 had the highest rate of rebleeding(P<0.001),and patients with modified Fisher grade 2 had the highest rate of rebleeding(P<0.001),while there was no statistically significant difference in the rate of bleeding among patients with different tumor sizes(P=0.231).By test,the rate of rebleeding was higher in patients with seizures(87.5%)than in patients without seizures(12.5%)(P<0.001);The rebleeding rate was higher in patients with hematoma formation(91.1%)than in patients without hematoma formation(8.9%)(P<0.001).The rate of rebleeding was higher in patients with sentinel headache(89.3%)than in those without(10.7%)(P<0.001).There was no statistically significant difference in the rate of rebleeding of aneurysms in anterior circulation(92.9%)versus posterior circulation(7.1%)(P=0.882).The age of the non-rebleeding group(61.12 ± 14.78)and the rebleeding group(61.98±12.56)was determined by two independent samples t-test(P=0.685).Blood glucose in the non-rebleeding group(6.50±3.64)and the rebleeding group(7.28±3.92)(P=0.147).(3)Spearman correlation analysis:Hunt-Hess grading(r=0.367).The Fisher classification(r=0.253).Epileptic seizure(r=0.889).Hematoma formation(r=0.872).Sentinel headache(r=0.901).(4)Multivariate Logistic regression analysis was used,in which hematoma formation(P<0.001);Sentinel headache(P<0.001)Conclusion:(1)Rebleeding occurred in 56 of 305 ASAH patients preoperatively,and the incidence of rebleeding was 18.4%(56/305).(2)There was a positive correlation between Hunt-Hess grading and rebleeding with low intensity(r=0.367).There was a weak positive correlation between improved Fisher grading and rebleeding(r=0.253).There was a high positive correlation between epileptic seizure and rebleeding(r=0.889).There was a high positive correlation between hematoma formation and rebleeding(r=0.872).Hematoma formation(P<0.001);Sentinel headache(P<0.001)was an underlying risk factor for rebleeding.