Analysis Of Risk Factors For Rebleeding Of Aneurysmal Subarachnoid Hemorrhage

ObjectiveTo investigate risk factors of the rebleeding in patients with aneurysmal subarachnoid hemorrhage, provide the basis for early clinical prevention.MethodsA retrospective analysis clinical data of254aneurysmal subarachnoid hemorrhage patients treated in Tianjin Huan Hu Hospital neurosurgery from January2010to October2013. According to rebleeding they were divided into2groups:28with rebleeding after aneurysmal subarachnoid hemorrhage and226aneurysmal subarachnoid hemorrhage without rebleeding randomly.Related risk factors for the two groups of patients were compared. Statistical methods were used to analyze the relationship between rebleeding and the patient’s gender, age,intervention time, past hypertension, past hyperlipidemia, past diabetes,smoking history,drinking history, aneurysm’s presence ascus,location,shape, size and number of the aneurysm, Fisher grade, Hunt-Hess Score,hypertension grade and Glasgow Outcome Score (COS). Statistical analysis were performed with the SPSS statistical package17.0.Results:1. Univariate analysis showed that the patient’s age,intervention time,aneurysm’s presence ascus, size of the aneurysm, merger a high level of Fisher grade,a high level of H-H Score,and hypertension grade have difference statistically between two groups.2. Multivariate logistic regression analysis showed that a high level of hypertension grade(level2-3),a high level of Fisher grade(level3-4)and Hunt-Hess Score(level3-5), presence of ascus and size of the aneurysm were independent risk factors for aneurysmal subarachnoid hemorrhage rebleeding.3. There are not difference statistically in patient’s gender, past hypertension,past hyperlipidemia, past diabetes, smoking history, drinking history,location,shape and number of the aneurysms between two groups.4. Univariate analysis showed that the patient’s GOS score have difference statistically between the two groups,the GOS score of patients in rebleeding group was significantly lower than the control group.5. The mortality rate of rebleeding group was42.9%(12/28),and the mortality rate of control group was10.2%(23/226), there was significant difference statistically between the two groups.Conclusion:1. Systolic blood pressure≥160mmHg, Fisher grade(level3-4), H-H Score(level3-5), presence of ascus and aneurysm diameter were independent risk factors for aneurysmal subarachnoid hemorrhage rebleeding.2. It is indicated that early surgery or endovascular treatment could reduce the incidence of aneurysmal subarachnoid hemorrhage rebleeding.3. The rebleeding of aneurysmal subarachnoid hemorrhage markedly increased the mortality and disability rate of the patients.