Analysis Of Relevant Risk Factors Of Cerebral Herniation And Clinical Prognosis In Patients With Massive Cerebral Infarction

Objective: To explore the related factors affecting cerebral hernia,transformation of intracranial hemorrhage,and mortality during hospitalization in patients with massive cerebral infarction(MCI),and to analyze the clinical significance of the related factors in the prognosis of patients with MCI,so as to provide a reference basis for the condition evaluation and clinical treatment of MCI patients.Methods: A total of 151 patients with MCI who were hospitalized in the Department of Neurology of Guangxi Zhuang Autonomous Region People’s Hospital from January 1,2020 to December 31,2022 were included as subjects by retrospective analysis.After admission,blood routine,blood lipid,blood sugar and other related indicators were tested,clinical data such as age,gender,clinical performance,risk factors,treatment and complications were collected,and SPSS24.0 statistical software was used to explore the related factors affecting cerebral hernia,intracranial hemorrhage and hospitalization mortality in patients with MCI.The receiver operating characteristic curve(ROC)was used to analyze the role of patient related risk factors in the evaluation of MCI prognosis.Results:(1)The incidence of cerebral hernia,mortality rate and intracranial hemo rrhage conversion was 34.4%,36.4% and 31.8% respectively in 151 patients with MC I during hospitalization.(2)Diabetes,impaired consciousness on admission,pneumonia and aspartate transferase were independent influencing factors for cerebral hernia formation in patients with MCI.Diabetes(OR=2.849,95%CI:1.221-6.649,P=0.015)was associated with hernia in MCI.The area under the diabetes curve was 0.612.(3)Atrial fibrillation,vascular intervention,intravenous thrombolytic therapy and fibrin ogen were independent factors for the transformation of intracranial hemorrhage in MC I.Atrial fibrillation(OR=2.216,95%CI:1.040-4.721,P=0.039)was associated with the transformation of intracranial hemorrhage in MCI,and the area under the curve was 0.609.(4)Diabetes,atrial fibrillation,transformation of intracranial hemorrhage,cerebral hern ia,decompression of bone valve,pneumonia and neutrophil/lymphocyte ratio were inde pendent influencing factors for death during hospitalization in MCI patients.Three fact ors including diabetes(OR=2.584,95%CI:1.170-5.706,P=0.019),atrial fibrillation(OR=3.306,95%CI:1.297-7.105,P=0.010)and transformation of intracranial hemorrhage(OR=3.752,95%CI:1.537-9.158,P=0.004)were associated with death during MCI hospitali zation.The area under the transformation curve of diabetes,atrial fibrillation and intra cranial hemorrhage were 0.619,0.581 and 0.593,respectively.Conclusion:(1)Diabetes,impaired consciousness on admission,pneumonia and as partate transferase were independent influencing factors for cerebral hernia formation in patients with MCI.Diabetes was associated with hernia in MCI.(2)Atrial fibrillatio n,vascular intervention,intravenous thrombolytic therapy and fibrinogen were independ ent influencing factors for the conversion of intracranial hemorrhage in patients with MCI.Diabetes,atrial fibrillation and intracranial hemorrhage transformation were associ ated with death in hospital during massive cerebral infarction.Atrial fibrillation has ev aluation value for the transformation of intracranial hemorrhage.(3)Diabetes,atrial fibr illation,transformation of intracranial hemorrhage,cerebral hernia,decompression of bo ne valve,pneumonia and neutrophil/lymphocyte ratio were independent influencing fact ors for death during hospitalization in MCI patients.Diabetes,atrial fibrillation and int racranial hemorrhage transformation were associated with death during MCI hospitalizat ion,which had reference value for the assessment of death during MCI hospitalization.