Analysis Of Risk Factors Of Delayed Cerebral Infarction After Aneurysm Subarachnoid Hemorrhage

Objective To summarize the incidence and time of Delayed cerebral ischemia(DCI)after Aneurysm subarachnoid hemorrhage(aSAH),and to explore its related risk factors.It provides reference for further prevention of DCI,and improvement of neurological prognosis in patients.Methods The clinical data of patients with aSAH admitted to our hospital from August 2012 to August 2018 was analyzed retrospectively.Collect general information about the patient,Including age,sex,past medical history,time of admission,treatment,Hunt-Hess grade,modified Fisher grade,ventricular hemorrhage,hydrocephalus,pneumonia,intracranial hematoma,acute brain edema,blood routine examination,lipid,electrolyte,liver function,renal function,uric acid,the location,size,shape of the aneurysm and so on.After strict screening,a total of 282 patients were divided into DCI group(n = 39)and non-DCI group(n = 143)according to whether DCI occurred or not.Univariate and multivariate Logistic regression analysis was performed to analyze the risk factors of DCI by SPSS22.0 statistical software.Results The incidence of DCI was 13.8%.The incidence of hypertension,ventricular hemorrhage and pneumonia in DCI group was higher than that in non-DCI group.The improved Fisher grade,Hunt-Hess grade,white blood cell count,lymphocyte count,albumin and serum uric acid were higher than those in non-DCI group.There was significant difference between groups(P < 0.05).The factors with statistical significance in the univariate analysis were analyzed by multi-factor analysis.Admission Hunt-Hess grade(OR=2.413,95% CI: 1.047 /5.563),modified Fisher grade(OR=2.593,95% CI:1.183 ~ 5.563),pneumonia(OR= 3.037,95% CI: 1.322 / 6.981)are an independent risk factor for DCI(all P < 0.05).Conclusions 1.Hunt-Hess grade,modified Fisher grade and pneumonia are independent risk factors of DCI in aSAH patients.2.although there are significant differences in hypertension,ventricular hemorrhage,white blood cell count,neutrophil count,albumin and uric acid between the two groups in univariate analysis,the correlation needs to be further studied,and the basis for independent prediction of DCI is not enough for the time being.