Risk Factors For Poor Prognosis After Interventional Rupture Of Intracranial Aneurysms

Objective:In order to further explore the prognosis and risk factors of rupture and hemorrhage of intracranial aneurysm in patients after endovascular intervention,we explored the influence of related factors.Methods:Methods a retrospective analysis was conducted on 223 hospitalized patients with ruptured intracranial aneurysms in the First Affiliated Hospital of Shantou University from the first half of 2017 to the first half of 2019.Univariate and multivariate Logistic regression analyses were performed to determine the prognostic effect of ruptured intracranial aneurysms.Results:The data of 223 patients with aneurysm rupture and hemorrhage were analyzed.Among them,155 cases of aneurysm rupture and hemorrhage had a good prognosis,while 68 cases of aneurysm rupture and hemorrhage had a poor prognosis.Univariate analysis showed age(χ~2=14.637,P<0.05),headache symptom at admission(χ~2=27.302,P<0.05),Hunt-Hess score Grade(χ~2=31.88,P<0.05),GCS score on admission(χ~2=39.741,P<0.05),intraoperative and postoperative vasospasm(χ~2=8.761,P=0.003),postoperative head CT reexamination revealed cerebral infarction/cerebral ischemia/intracranial low-density foci(χ~2=7.057,P=0.008),Fisher grade on admission(χ~2=3.955,P=0.047),blood glucose value on admission(8.0±2.2 vs 9.6±4.1,t=2.90,P<0.05),neutrophils size after admission(9.32±4.75 vs.13.35±5.76,t=5.136,P<0.05),leukocytosis after admission(11.79±4.51 vs.15.73±5.70,t=75.37,P<0.05)The two groups were statistically different in comparisont.Logistic reversion analysis showed that there was a significant relationship between age(≤55)and age(>55)(value reversion coefficient=0.032,P=0.047,the OR value=1.032)and postoperative complicated with cerebral infarction(regression coefficient=1.179,P=0.028,the OR value=0.308),GCS score on admission(value regression coefficient=0.386,P=0.016,the OR value=0.680),Fisher on admission and hunt-Hess classification(value regression coefficient=0.714,P=0.005,the OR value=2.042;Values of regression coefficients=0.602,P<0.01,OR value=1.825),intraoperative/postoperative complicated by cerebral vasospasm(regression coefficient=1.444,P=0.005,the OR value=0.236),white blood cells on admission value(value regression coefficient=0.112,P=0.001,the OR value=1.118),the operation time(value regression coefficient=0.853,P=0.033,the OR value=2.346)were significantly correlated with and risk of intracranial aneurysm rupture.Conclusion:single factor analysis,according to the results found that intracranial aneurysm patients age,there is no headache symptoms admission,Hunt-Hess grade points,GCS score on admission,intraoperative concurrent vasospasm after operation,postoperative review head CT found on focal cerebral ischemia/intracranial cerebral infarction low density foci,timing of surgery,and Fisher grade on admission,glucose on admission,neutrophils size after admission,white blood cells after admission lift is the influence factors of affect the prognosis of patients with intracranial aneurysms,It’s not atypical for different symptoms。(P<0.05,P<0.01);Multiariable logistic regression analysis suggest that patients with intraoperative caused by cerebral infarction after age,on admission,GCS score on admission,Fisher and hunthess grade on admission,intraoperative caused by cerebral vasospasm after/timing,leukocyte number on admission,surgery is the independent risk factors affecting prognosis,this for us to improve the prognosis of ruptured intracranial aneurysm bleeding has important significance.Early screening of CTA or DSA for some young people with symptoms can improve the prognosis of patients with more sophisticated intraoperative requirements for operators and standardized treatment after surgery,including early admission for preoperative blood examination and evaluation.