Risk Factor Analysis Of Delayed Cerebral Ischemia After Aneurysmal Subarachnoid Hemorrhage

Objective: Delayed cerebral ischemia(DCI)is one of the serious complications of intracranial aneurysmal subarachnoid hemorrhage(a SAH).The appearance of DCI often leads to a poor prognosis in patients with a SAH.This study aims to collect clinical information of a SAH patients and use statistical methods to screen out independent risk factors that can predict the occurrence of DCI,so as to identify high-risk DCI patients as early as possible and carry out effective interventions to improve the prognosis of a SAH patients.Methods: This study retrospectively analyzed patients with aneurysmal subarachnoid hemorrhage who were treated in the Department of Neurosurgery,the XXX Hospital from March 2018 to December 2020.The patients were classified to a DCI group and a non-DCI group according to whether the occurrence of DCI.General information of patients was collected.Univariate and multivariate regression analyses were used to screen the independent risk factors for DCI after a SAH via SPSS24.0.Results: A total of 203 patients with a SAH were collected in this study.The incidence of DCI was 31.5%(64/203).In univariate analyses,there were significant differences between the DCI group and non-DCI group(P < 0.05)in the comparison of modified Fisher grade,Hunt-Hess classification,WFNS grade,history of hypertension,white blood cell count,lymphocyte count,acute cerebral edema,and maximum diameter of aneurysm.There were no significant differences in gender,age,smoking history,history of diabetes,history of drinking,location of aneurysm,operation method,operation duration,blood sodium,serum potassium,blood glucose,hemoglobin,albumin,platelet count,neutral granulocyte count and NLR between the 2 groups.(P> 0.05).The 8 variables in the univariate analysis that are related to the occurrence of DCI after a SAH were used as the independent variables for multivariate analysis.The results showed that modified Fisher grade≥ Ⅲ,Hunt-Hess grade≥ Ⅲ grade,WFNS grade≥ IV,history of hypertension and acute cerebral edema were independent risk factors for occurring DCI in patients with a SAH(P<0.05).However,elevated white blood cell count,elevated lymphocyte count,and maximum diameter of aneurysm were not risk factors for occurring DCI in patients with a SAH(P>0.05).The proportion of mortality and moderate to severe disability in the DCI group was higher than that of the non-DCI group,and the proportion of good recovery and mild disability was lower than that of the no DCI group.Conclusion: High-level Hunt-Hess grade,high-level modified Fisher grade,high-level WFNS grade,history of hypertension and acute cerebral edema were independent risk factors for DCI in patients with a SAH.Patients with a SAH with the above characteristics should be closely monitored.The occurrence of DCI is closely related to the poor prognosis of a SAH patients.