Risk Factors Of Intracranial Aneurysms In Patients With Subarachnoid Hemorrhage

Purpose:Intracranial aneurysmal subarachnoid hemorrhage has a higher mortality and disability,especially when the aneurysm is ruptured for the second time,which can lead to a worse prognosis,most of the rebleeding occurred within 72 hours after the first bleeding.In actual clinical work,there is a certain time interval between patients undergoing confirmatory imaging examination of aneurysm after admission.This period of time is particularly important for the strict management of patients to reduce the risk of secondary aneurysm rupture.Therefore,finding risk factors for intracranial aneurysms in patients with spontaneous subarachnoid hemorrhage has important guiding significance for clinical work.The study is ames to evaluate the clinical data of patients with spontaneous subarachnoid hemorrhage by age,gender,hypertension,smoking,alcohol,Hijdra sum score,modified Fisher grade,and HUNT-HESS grade to explore this type Related risk factors for patients with intracranial aneurysms.Methods:We retrospectively analyzed the clinical data of 183 patients with spontaneous subarachnoid hemorrhage diagnosed by CT scan of the brain from April 2018 to January 2020 in the Neurosurgery Department of Tianjin Medical University General Hospital.These patients were divided into aneurysm group(positive group)and non-aneurysm group(negative group)according to the presence of intracranial aneurysms,aneurysms were diagnosed by CT angiography(head CTA),magnetic resonance angiography(head MRA),or digital subtraction angiography(DSA).Any one of the positive tests was included in the aneurysm group.Patients were included in the aneurysm group if any of the imaging methods showed a positive aneurysm.DSA negative was used as the inclusion criterion in the aneurysm negative group.The clinical characteristics including age,gender,hypertension,smoking,alcohol,modified Fisher grade,HUNT-HESS grade,and Hijdra sum score between two group were collected for univariate analysis.According to the results of the analysis,binary logistic regression analysis was used to investigrated the risk factors of intracranial aneurysm in patients with subarachnoid hemorrhage.Results:(1)There were 126 cases in the positive group and 57 cases in the negative group.The modified Fisher grade and Hunt-Hess grade were transformed into binary variables,univariate analysis was used to analyze the differences between the two groups.The results showed that there was no significant difference in age(χ~2=1.317,P=0.253),gender(χ~2=2.593,P=0.107),drinking history(χ~2=1.555,P=0.212)and hypertension history(χ~2=1.985,P=0.159)between the two groups(P>0.05).The differences in smoking(χ~2=5.618,P=0.018),modified Fisher grade 3-4(χ~2=9.219,P=0.002),Hunt-Hess grade 4-5(χ~2=6.183,P=0.013),and Hijdra sum score(χ~2=6.677,P=0.011)were statistically significant(P<0.05).(2)The binary logistic regression analysis was used to evaluated statistically significant factors.The results showed that smoking(P=0.012,OR=2.662)and Hijdra sum score(P=0.042,OR=1.090)were independent risk factors for risk of intracranial aneurysm in patients with spontaneous SAH.Conclusion:Smoking history,Hijdra total score,m Fisher grade,Hunt-Hess grade are significantly different between patients with aneurysm-positive subarachnoid hemorrhage and patients with aneurysm-negative subarachnoid hemorrhage.Smoking history and Hijdra total score are independent risk factors for patients with spontaneous subarachnoid hemorrhage having intracranial aneurysms.Patients with smoking history and high Hijdra total score have a higher risk of intracranial aneurysms.