The Predictive Value Of MGs Score In The Poor Prognosis Of Patients With Aneurysmal Subarachnoid Hemorrhage And Intraventricular Hemorrhage After Coil Embolization

Aim Aneurysmal subarachnoid hemorrhage is a common emergency and critical illness in neurological clinic with the characteristics of high fatality rate and high disability rate.The course and prognosis of patients with a SAH was aggravated by the concomitant ventricular hemorrhage.The predictive value of the modified Graeb scale(m GS)score of intraventricular hemorrhage in patients with a SAH and IVH after coil embolization was explored in order to achieve the early identification of high-risk patients,it is conducive to the early intervention of such patients.MethodPatients with a SAH and IVH received coil embolization treatment were retrospectively included in the Department of Neurology of Fujian Provincial Hospital from January2016 to February 2020.Patient’s baseline data,Glasgow Coma Scale(GCS)score,Hunt-Hess grade,modified Fisher grade,m GS score,the location and length of aneurysm,coil embolization method,and perioperative complications were collected.The modified Rankin Scale(m RS)score was used to evaluate the prognosis at 90 d after patients were discharged.The poor prognosis was defined as m RS more than 2 points.Multivariable logistic regression analysis was used to determine the independent risk factors for poor prognosis.The receiver operating characteristic curve(ROC)was used to evaluate the predictive value of m GS sore for poor prognosis.ResultA total of 111 patients were enrolled and 71 patients(63.96%)were in the good prognosis group and 40 patients(36.04%)were in the poor prognosis group.The average age and serum c Tn I level of patients in the poor prognosis group were significantly higher than that in the good prognosis group(P<0.05).Compared with the good prognosis group,the poor prognosis group had higher Hunt-Hess grade,modified Fisher grade,Barrow Neurological Institute(BNI)grading scale,Subarachnoid hemorrhage Early Brain Edema Score(SEBES),m GS score and lower GCS score(P<0.05)than that of good prognosis group.The proportion of hydrocephalus and delayed cerebral ischemia(DCI)in the poor prognosis group were also higher than that in the good prognosis group(P<0.05).By means of multivariable logistic regression analysis after adjusting for other confounding factors,age [odds ratio(OR)1.083,95%confidence interval(CI)1.011～1.160;P=0.023],delayed cerebral ischemia(OR 38.527,95% CI 5.930 ～ 250.317;P < 0.001)and m GS(OR 1.366,95% CI 1.119～1.668;P=0.002)were independent predictors of poor prognosis.The area under the curve(AUC)of m GS predicting poor prognosis is 0.795(95%CI 0.704～0.885;P<0.001),the best cutoff value is 7.5,the Youden index is 0.501 and the corresponding sensitivity and specificity are 82.5% and 67.6% respectively.ConclusionThe age,m GS score and DCI were independent risk factors for poor prognosis in patients with a SAH and IVH undergoing coil embolization treatment.In the mean time,m GS score was a certain predictive value scale for patients with poor prognosis and the patients with more than 7.5 m GS score had even worse prognosis.