Study On Predictive Factors Of Delayed Cerebral Ischemia After Aneurysm Embolization And A New Predictive Scoring System

ObjectiveSpontaneous Subarachnoid Hemorrhage(SAH)is a neurosurgical emergency with high mortality and disability.The evolution and prognosis of the condition after bleeding are affected by the patient's previous general conditions,clinical symptoms at admission,imaging manifestations,and corresponding laboratory inflammatory factors.In the past,more systematic scoring systems have been proposed,which have certain effects on evaluating the severity of clinical symptoms and predicting the occurrence and prognosis of complications such as delayed cerebral ischemia(Delayed Cerebral Ischemia,DCI),and have significant help in clinical decision-making.At present,intravascular interventional treatment is getting more and more attention.This time,the purpose of this study was to explore the factors that affect the occurrence of DCI after aneurysmal Subarachnoid Hemorrhage(aSAH)embolization.MethodsThis study intends to find relevant clinical,imaging and laboratory inflammation data on aSAH patients undergoing embolization in the Department of Neurosurgery of Zhejiang People's Hospital from January 1,2017 to December 31,2019.Sexuality may affect factors.A multi-factor analysis is used to establish a related scoring system to quickly predict the occurrence of DCI.And then,the ROC curve evaluation scoring system was compared with other scoring systems.ResultsA total of 94 patients after aSAH embolization were included in the study.According to univariate analysis,P<0.05 was included in the results of multivariate regression analysis,and through stepwise logistic regression,in order to better predict DCI,the white blood cell level(OR:2.28,95%CI:0.767?6.76;P=0.136),mFS The scores(OR:3.25,95%CI:0.678?14.86;P=0.126)and HH scores(OR:4.17,95%,CI:0.75?26.35;P=0.109)are included in the proposed new scoring system.By constructing a line chart and equivalently reducing the weight of each factor,the scoring standards are set as follows:white blood cells(?10×10^9/L=0,>10×10^9/L=2),mFS score(0?2 points=0,3?4 points=3),HH(???=0,???=4).The possibility of DCI increases while the score increases.Finally,through ROC analysis and evaluation of the new score RNI and IDI values,it was concluded that the new score has improved the ability to predict DCI and prognosis to a certain extent.ConclusionThe new scoring system combining clinical symptoms,imaging manifestations,and inflammation indicators has a good assessment of early disease severity and predicts DCI and other adverse prognosis.