Prognostic factors of patients with intracranial aneurysms undergoing endovascular therapy
Journal Title: Journal of Air Force Medical University - Year 2023, Vol 44, Issue 4
Abstract
Objective To explore the prognostic factors of patients with intracranial aneurysms undergoing endovascular therapy. Methods A total of 725 patients with intracranial aneurysms undergoing endovascular therapy in the Department of Neurosurgery, Xijing Hospital, Air Force Medical University from January 2011 to June 2020 were selected. The modified Rankin Scale ( mRS) was used 30 d after surgery to evaluate the prognosis of patients, and univariate and multivariate logistic analysis was used to analyze the influencing factors of the prognosis of patients. Results Thirty days after endovascular therapy, 613 cases (84. 6% ) had good prognosis and 112 cases (15. 4% ) had poor prognosis. The univariate analysis showed that there were significant differences between the poor prognosis group and good prognosis group in age, timing of surgery ( emergency or elective surgery), history of hypertension, number of aneurysms ( single / multiple ), preoperative aneurysm rupture, preoperative Hunt-Hess grade, preoperative Fisher grade, American Society of Anesthesiologists (ASA) classification, awake or not and extubation or not when leaving the operating room, duration of surgery, duration of anesthesia, and preoperative D-dimer level (P < 0. 05). The multivariate logistic regression analysis of the factors with P < 0. 2 in univariate analysis showed that preoperative Hunt-Hess grade (OR = 2. 494, 95% CI: 1. 462 - 4. 255), preoperative Fisher grade (OR = 4. 679, 95% CI: 2. 197 - 9. 963), ASA classification ( OR = 1. 594, 95% CI:0. 933 - 2. 722), preoperative D-dimer level ( OR = 1. 322, 95% CI: 1. 072 - 1. 629), failure to wake when leaving the operating room (OR = 6. 510, 95% CI: 3. 706 - 11. 437) and duration of anesthesia ( OR = 1. 323, 95% CI: 1. 053 - 1. 661) were associated with the prognosis of patients. Conclusion Preoperative Hunt-Hess grade, preoperative Fisher grade, ASA classification, preoperative D-dimer level, failure to wake when leaving the operating room, and duration of anesthesia are influencing factors of poor prognosis in patients with intracranial aneurysm undergoing endovascular therapy.
Authors and Affiliations
YANG Manping, TUO Xiaoshuang, LIU Xiaoyu, ZHANG Junbao, SHI Liwen, ZHANG Minjuan, HE Shan, LU Zhihong
Keywords
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