Risk Factor Analysis Of Delayed Cerebral Ischemia After Aneurysmal Subarachnoid Hemorrhage

Objective:This article retrospectively analyzes the factors of delayed cerebral ischemia(DCI)after aneurysmal subarachnoid hemorrhage(a SAH),it is hoped that the development of the disease can be predicted early in the clinical work,and timely prevention and symptomatic treatment can be made to reduce the damage of neurological function and improve the prognosis of patients.Methods:From January 2020 to November 2020,109 patients with a SAH in the Department of Neurosurgery of our hospital,75 patients met the requirements of this study after screening.According to whether DCI occurred,they were divided into delayed cerebral ischemia group(DCI,n=23)and no delayed cerebral ischemia group(no-DCI,n=52).Collect relevant clinical data,such as general admissions,aneurysm location,size,selection of surgical methods,admission grades of patients with a SAH,various laboratory indicators,etc.Use SPSS19.0 software for statistical analysis.The general condition of the patient,basic medical history,surgical method,preoperative grade,aneurysm factors and laboratory test data were single-factor analysis,and the statistically significant factors were found and then further multi-factor Logistic regression analysis was performed.At P<0.05,the difference is statistically significant.Multi-angle analysis of the related risk factors of delayed cerebral ischemia after aneurysmal subarachnoid hemorrhage.Results:A total of 75 patients with a SAH receiving treatment were enrolled in this study.Among them,a total of 23 patients developed DCI,and the incidence of DCI was30.7%.Univariate analysis demonstrated that gender(P=0.491),age(P=0.126),heart disease(P=0.133),diabetes(P=0.778),smoking(P=0.286),drinking(P=0.183),hypertension(P=0.55),location of aneurysm(P=0.578),size of aneurysm(P=0.416),operation methods(P=0.624),modified Fisher classification(P=0.104),blood calcium(P=0.622)and blood calcium(P=0.622)Sugar(P=0.376),PT(P=0.670),INR(P=0.719),APTT(P=0.591),TT(P=0.265),ALB(P=0.843),blood potassium(P=0.003),Among them,blood potassium level(P=0.003),Hunt-Hess grade(P=0.0003)and whether DCI occurred were significantly different(P<0.05).Other statistical information,such as the general condition of the patient(gender,medical history,etc.),aneurysm factors,surgical methods,blood calcium,coagulation-related tests on admission,blood albumin,modified Fisher grade and DCI are not obvious relationship.Multivariate logistic regression analysis showed that Hunt-Hess classification was risk factors for DCI in a SAH patients.Conclusions:1.Serum potassium level lower than normal(K~+<3.5mmol/L)at admission is associated with the risk of DCI,but the related risks still need to be further verified.2.Compared with hospitalized patients with Hunt-Hess grade I and II,patients with grade III and IV had a significantly higher risk of late ischemia.3.In clinical work,early dynamic monitoring of patients’serum potassium level should be carried out to correct hypokalemia in time,so that patients can obtain maximum benefits and better prognosis.4.For patients with higher Hunt-Hess grading,the monitoring of cerebral perfusion and oxygen saturation should be strengthened as soon as possible,in order to prevent the occurrence of DCI at an early stage,improve the prognosis of patients and consolidate the effect after surgical treatment.