Construction And Verification Of Risk Prediction Model For Aseptic Meningitis After Cranial Nerve Microvascular Decompression

Objective: The corresponding aseptic meningitis model was established to analyze the possibility of aseptic meningitis in patients after cranial nerve microvascular decompression.Methods Relevant data of patients with trigeminal neuralgia and hemifacial spasm in 4departments of neurosurgery in the affiliated hospital of Xinjiang Medical University from June 2020 to June 2022 were obtained by convenient sampling.300 patients belong to the model group.According to the clinical symptoms after operation and the absence of bacteria in cerebrospinal fluid,they are definitely sterile meningitis.The relevant influencing factors of aseptic meningitis were identified by logistic analysis,and the prediction model was constructed;Draw the characteristic curve of the subject and calculate the area under the curve(AUC),and select Medcalc to carry out AUC comparison..Results: Of the 300 patients included in the modeling group,131(43.7%)were diagnosed as aseptic meningitis.The results of univariate analysis showed that the history of hypertension,disease name,history of coronary heart disease,history of two operations,responsible blood vessel,duration of disease,age and intraoperative bleeding volume were the influencing factors of patients with aseptic meningitis after craniocerebral microvascular decompression(all P<0.05).Further multivariate logistic regression analysis showed that,Intraoperative bleeding(OR=1.030,95% CI: 1.018～1.048,P<0.005),hypertension(OR=12.154,95% CI:4.906～30.109,P<0.005),smoking(OR=16.871,95% CI: 6.006～47.386,P<0.005),two operations(OR=14.559,95% CI: 4.330～48.956,P<0.005)Responsibility vessel(OR=25.264,95% CI: 10.176～62.723,P<0.005)and duration of disease(OR=1.749,95%CI: 1.099～2.783,P<0.005).Among them,intraoperative bleeding volume(OR=1.030,95%CI: 1.018～1.048,P<0.005),hypertension(OR=12.154,95% CI: 4.906～30.109,P<0.005),smoking(OR=16.871,95% CI: 6.006～47.386,P<0.005)Two operations(OR=14.559,95%CI: 4.330～48.956,P<0.005)and the increase of the duration of disease(OR=1.749,95% CI:1.099～2.783,P<0.005)are the risk factors for the occurrence of aseptic meningitis.Conclusion: The risk prediction model of aseptic meningitis based on clinical parameters is simple,convenient and highly specific,which can provide reference for the prevention,evaluation and diagnosis and treatment of aseptic meningitis after cranial nerve microvascular surgery.