Prospective Study Of Prognosis Index Of Neurosurgery Patients

Objective The objective of this study was to assess predictors of prognosis in patients undergoing neurosurgical procedure and general anesthesia as well as to compare the efficiency of current preoperative evaluation systems predicting patients’prognosis in order to guide the implementation of anesthesia and surgery.Method From a prospective neurosurgery registry,505patients who underwent neurosurgical procedure and general anesthesia in Xiangya hospital between April2013and May2013were followed until discharged from hospital, and used GCS Outcome Score (GOS) to define the prognosis. Chi-square test was used to identify the single factors of prognosis from14factors, including gender, age, type of procedure, etiology, hypertension, preoperative GCS score, preoperative APACHE Ⅱ score, ASA classification, Anesthesia Grading, grading of operation, operation time, intraoperative CRE, intraoperative blood transfusion, and postoperative fever. Two classification Logistic Regression was performed to analyze14prognostic factors.Results There are12factors have statistically significant difference with prognosis, including age, type of procedure, etiology, hypertension, preoperative GCS score, preoperative APACHE Ⅱ score, ASA classification, anesthesia classification, grading of operation, intraoperative CRE, intraoperative blood transfusion, and postoperative fever. Two classification Logistic Regression find that Anesthesia Grading, ASA grading and APACHE Ⅱ score are predictors of poor prognosis in patients(P<0.05). Their relative risks are3.333(CI1.456-7.626),1.910(CI1.223-2.984) and1.112(CI1.049-1.178) respectively.Conclusion There are12factors affect prognosis, including age, type of procedure, etiology, hypertension, preoperative GCS score, preoperative APACHE Ⅱ score, ASA classification, anesthesia classification, grading of operation, intraoperative CRE, intraoperative blood transfusion, and postoperative fever. Anesthesia Grading, ASA grading and APACHE Ⅱ score are predictors of poor prognosis in patients. Anesthesia Grading System can be used as a significant predictor of prognosis in patients undergoing neurosurgical procedure.