Analysis Of Elevant Factors For Cognitive Impairment After Aneurysmal Subarachnoid Hemorrhage

Objective:Retrospective analysis of all patients who met the inclusion criteria for intracranial aneurysm rupture with subarachnoid hemorrhage were hospitalized in the neurosurgery of the Second Affiliated Hospital of Kunming Medical University from November 2015 to May 2017,studied their cognitive status,and analyzed Relevant influencing factors.Methods:We have collected a total of 15 items of all cases,including gender,age,history of hypertension and diabetes,GCS score,Fisher score,Hunt&Hess grade,smoking history,GOS score(discharged),location of ruptured aneurysm,intraoperative aneurysm rupture,surgical timing,postoperative complications(Cerebral vasospasm,hydrocephalus,epilepsy).All patients were assessed using the MoCA scale as an evaluation indicator of cognitive impairment at 3 days after surgery,at discharge,and 1 month after discharge.The above-mentioned factors were analyzed by univariate analysis and statistically significant factors were analyzed by Logistic regression.Results:A total of 70 cases were collected.There were 54 cases(77.14%),36 cases(51.43%),and 28 cases(40.00%)with cognitive impairment 3 days after surgery,at discharge,and 1 month after discharge.The incidence of cognitive impairment was significantly higher than at discharge and 1 month after discharge(P<0.05).The GCS score had a significant effect on cognitive impairment at 3 days postoperatively(P=0.008).The surgical timing at discharge was a significant contributor to cognitive impairment in patients(P=0.037).The Fisher classification(P=0.017),Hunt&Hess analysis(P=0.017),and GOS score(P=0.003)were independent risk factors for cognitive impairment in the first month of hospital discharge.Conclusions:The incidence of cognitive impairment in the acute stage of subarachnoid hemorrhage is high.With the treatment of the primary disease and later rehabilitation,some of the cognitive impairment can be gradually restored;The factors affecting cognitive impairment are different in different stages of disease.The lower the GCS score,the higher of cognitive impairment in patients with early stage of postoperative surgery.Early postoperative surgery may reduce the cognitive impairment occurring when the patient is discharged.The higher the Fisher's grade and Hunt&Hess level,the greater of the sustained cognitive impairment,and the higher the GOS score,the less of persistent cognitive impairment.