| Objective Quantitative electroencephalogram combined with transcranial doppler ultrasound application in aneurysmal subarachnoid hemorrhage patients a dynamic monitoring and analysis what indicators can be used as a predictor of late-onset cerebral ischemia occurs,and compare the two joint after the prediction performance is better than used alone,in order to explore the relatively simple,accurate and objective prediction method,easy to provide better guidance for clinical.Methods The baseline and clinical data of 54 patients with aneurysmal subarachnoid hemorrhage(aSAH)admitted to the Department of Neurology and surgery from December2019 to 2021 were collected Quantitative electroencephalography(QEEG)and transcranial Doppler ultrasound(TCD)were performed within 24 hours after admission.The end points were Delayed cerebral ischemia(DCI)or 14 days after onset,according to the criteria of DCI,the patients were divided into two groups: the Presence Group and the absence group;the differences between the two groups were analyzed by logistic regression analysis,finally,the ROC curve was used to analyze whether the combination of QEEG and TCD was the best.Results(1)Baseline data: gender,age,smoking history,drinking history,hypertension,diabetes,previous history of stroke or TIA,Hunt-Hess score at admission showed no statistical difference between the two groups(P > 0.05).There was a statistical difference between the two groups(P < 0.05)when Fisher grading was modified on admission.(2)Clinical data: In TCD-related indexes,VS,VM and PI values showed statistically significant differences between the two groups(P < 0.05),while there was no significant difference in VD between the two groups(P > 0.05).In QEEG-related indicators,RDP,RAP,ADR and relative α were different between the two groups(P < 0.05).There was no statistical difference between RTP,RBP and ABDTR groups(P > 0.05).(3)All variables with P < 0.05 in univariate analysis were entered into the logistic regression model with DCI group as the dependent variable.The results showed that only ADR value(OR=1.536,95%CI 1.046-2.257,P=0.029)and Vm value(OR=2.543,95%CI 1.440-14.695,P= 0.037)could be used as independent predictors of DCI after SAH.(4)The ROC curve was further developed,and the results showed that the predictive efficacy of QEEG combined with TCD(AUC 0.946,95%CI 0.888-1.000)was significantly better than that of QEEG alone(AUC 0.844,95%CI 0.714-0.913),TCD(AUC0.771,95%CI 0.624-0.919)and improved Fisher grading(AUC 0.679,95%CI 0.508-0.850).Conclusion(1)Both QEEG and TCD can be used to predict DCI after aSAH.(2)Modified Fisher grade ≥III may be a related risk factor for DCI in patients with aSAH.(3)Among QEEG and TCD related indicators,ADR and Vm values can be used as independent predictors of DCI occurrence,and RDP,RAP,relative variation,Vs and PI values also have high reference value.(4)QEEG combined with TCD is more effective than each single one in predicting DCI occurrence,and has important value in clinical work,which is worthy of clinical application and promotion. |
