The Discussion Of The Level Of Serum Lactate Dehydrogenase In Postoperative Pneumonia Of Patients With Aneurysmal Subarachnoid Hemorrhage

Objective: To investigate whether Lactate dehydrogenase(LDH)levels in patients with aneurysmal subarachnoid hemorrhage(aSAH)are feasible to predict the occurrence of postoperative pneumonia(POP).Methods: A total of 322 patients who were diagnosed with aSAH in affiliated hospital of Jining Medical College,from January 1,2016 to December 31,2018 and were diagnosed with aSAH at the age of 18 years and older were selected.General information about the patient was collected including name,age,gender,past medical history,smoking and drinking,white blood cell levels at admission,blood glucose,blood potassium,blood sodium,lactate dehydrogenase levels,Hunt-Hess grade,modified Fisher score,arteries Corresponding information such as tumor location and surgical method.Group according to the presence or absence of postoperative pneumonia,and perform univariate and multivariate analysis on the above indicators.Draw the working characteristics of the subjects based on the LDH,Hunt-Hess classification,modified Fisher score,and white blood cell level at admission.Receiver operator characteristic curve(ROC curve),and calculate the AUC area,optimal threshold,sensitivity,specificity and Judden index of each indicator,and compare whether there is statistical difference in AUC area between the above indicators.And analyze the difference in the incidence of POP among aSAH patients with different grades and LDH levels.Results: In this study,there were 118 patients(36.65%)with POP.The LDH levels in patients in the POP group were significantly higher than those in the non-POP group(233.81 ± 71.51 U / L,and 188.18 ± 47.39 U / L,P <0.001).Multivariate analysis showed that even after adjusting for possible confounding factors,LDH levels remained an important independent factor associated with POP in aSAH patients.ROC curve analysis showed that the optimal threshold value of LDH was 211.5U / L,the sensitivity was 63.6%,and the specificity was 78.9%.There may be an additive interaction between elevated LDH levels and Hunt-Hess classification.When classifying patients according to the Hunt-Hess classification,regardless of the Hunt-Hess classification(Hunt-Hess classification <3 or ? 3),the POP-free rate of patients admitted with LDH ? 240 U / L was significantly worse than LDH <240 U / L.Conclusions:(1)High LDH level at admission,history of hypertension,high Fisher score at admission,high Hunt-Hess score at admission,and high WBC level at admission are risk factors for postoperative pneumonia after aneurysmal subarachnoid hemorrhage.(2)LDH might be a important predictor for early identification of POP occurrence in aSAH patients.(3)There were additive interactions between elevated LDH level and Hunt-Hess grade.