| Objective:To investigate the value of early brain edema score(SEBES)on evaluating prognosis in patients with aSAH and guide clinical work.Methods: Clinical data of 144 aSAH patients hospitalized in the Department of Neurosurgery,Zhangjiajie Hospital Affiliated to Hunan Normal University from January 2018 to October 2020 were retrospectively analyzed.The data of SEBES grade on admission,Fisher grade,Glasgow Coma Score(GCS),Hunt-Hess classification,World Federation of Neurological Societies(WFNS),age,gender,the size of the aneurysm and location,peripheral white blood cell counts,neutrophil ratio,lymphocyte ratio,blood glucose level,serum potassium level,serum sodium level,blood pressure on admission,whether to remove the bone flap for decompression and put external ventricular drainage,and other clinical data were collected.Single-factor and binary logistic regression analysis was carried out on these data to explore the factors infecting prognosis,then drawn the ROC curve.And investigating the role of SEBES on evaluating the prognosis after aneurysm ruptured.Results: SEBES(P=0.000,OR=0.032,95% C.I.=0.005-0.191),Fisher classificati-on (P=0.004,OR=0.069,95% C.I.=0.011-0.434),blood glucose level(P=0.041,OR=0.27,95% C.I.=0.077-0.946),GCS score <8 score(P=0.026,OR=4.95,95% C.I.=1.207-20.306)were independent predictors for poor prognosis.Prognostic effica-cy was predicted based on the area under the curve of ROC and the progno-stic efficacy was in descending order: SEBES(AUC=0.777,95% C.I.=0.687-0.868),Fisher grade(AUC=0.769,95%C.I.=0.664-0.874),Hunt-Hess classification(AUC=0.765,95% C.I.=0.661-0.87),Age(AUC=0.715,95% C.I.=0.623-0.807),blood glu cose(AUC=0.647,95% C.I.=0.542-0.751).Further statistics showed that the best diagnostic threshold of SEBES was 3.50;The optimal diagnostic threshold of Hunt-Hess classification was 3.50;The best diagnostic threshold of Fisher’s class ification was 3.50;The optimal diagnostic threshold of blood glucose level was7.93;The optimal diagnostic threshold for age was 57.5 years.Conclusion: 1.SEBES is an independent risk factor for poor prognosis in aSAH patients,and can predict adverse outcomes in patients.2.The predictive value of SEBES may be higher than Hunt-Hess grade,Fisher grade,GCS score and blood glucose.3.The patients with SEBES(>3),Hunt-Hess classification(>3),Fisher grade(>3),blood glucose level(>7.93mmol/ L),age(>57.5years)are more likely to have a poorer prognosis. |
