Influence Factors Analysis Of Intracranial Infection After Anterior Circulation Ruptured Intracranial Aneurysm Clipping Operation

Objective:To investigate the related factors in patients with intracranial infection after clipping operation of ruptured aneurysm of intracranial anterior circulation.Methodology:From January 2015 to October 2020,217 patients that admitted in the Department of Neurosurgery,the Second Affiliated Hospital of Fujian Medical University were enrolled in the study.patients who were diagnosed by Computed Tomography Angiography(CTA),Magnetic Resonance Angiography(MRA)/Digital Substraction Angiography(DSA)were retrospectively analyzed.According to the clinical symptoms and signs of intracranial infection,these patients are divided into two groups:44 cases with intracranial infection and 173 cases with without intracranial infection.Retrospectively analyzed the clinical data of the two groups of patients,including 17 possible related factors such as age,gender,history of hypertension,history of diabetes,aneurysm size,aneurysm location,emergency surgery,Hunt-Hess grade before operation,intraoperative aneurysm rupture,decompressive craniectomy,size of craniotomy bone flap,intraoperative blood loss,number of intraoperative aneurysm clips,use artificial dura max,operation time,time to place external drainage tube after operation,preoperative blood routine white blood cell count,etc for statistical analysis.On this basis,relevant risk factors of intracranial infection after anterior circulation ruptured intracranial aneurysm clipping operation were found out and further discussed.Result:In this study,there were 217 cases of intracranial infection after anterior circulation ruptured intracranial aneurysm clipping operation,in which 44(account for 20.28%)are with intracranial infection and 173(account for 79.72%)without intracranial infection.Single factor analysis showed that aneurysm size,aneurysm location,Hunt-Hess grade before operation,size of craniotomy bone flap,operation time,time to place external drainage tube after operation,preoperative blood routine white blood cell count were significantly correlated with intracranial infection(p<0.05),while the age,gender,history of hypertension,history of diabetes,emergency surgery,intraoperative aneurysm rupture,decompressive craniectomy,intraoperative blood loss,number of intraoperative aneurysm clips,use artificial dura max were not significantly correlated with intracranial infection(P>0.05).Multiple factor analysis indicated that aneurysm location,operation time and time to place external drainage tube after operation are main risk factors of intracranial infection after anterior circulation ruptured intracranial aneurysm clipping operation.Conclusion: In summary,intracranial infection after anterior circulation ruptured intracranial aneurysm clipping operation is related to many factors.Single factor analysis showed that aneurysm size,aneurysm location,Hunt-Hess grade before operation,size of craniotomy bone flap,operation time,time to place external drainage tube after operation,preoperative blood routine white blood cell count were significantly correlated with intracranial infection(p<0.05).Multiple factor analysis indicated that aneurysm location[OR=1.723,95%CI(1.027,2.889)],operation time[OR=0.378,95%CI(0.161,0.887)]and time to place external drainage tube after operation[OR=0.238,95%CI(0.131,0.432)]are main risk factors of intracranial infection after anterior circulation ruptured intracranial aneurysm clipping operation.Time to place external drainage tube after operation is the most relevant factor for the occurrence of intracranial infection after clipping operation of the ruptured intracranial aneurysm.The longer the placement of the external drainage,the higher the risk of intracranial infection.