Multivariate Analysis Of Predictors Of Delayed Ischemic Neurological Deficit Occurrence After Aneurysmal Subarachnoid Hemorrhage Department Of Neurosurgery

Objective Delayed ischemic neurological deficit (DIND) as serious complication after aneurysmal subarachnoid hemorrhage (SAH) is a kind of cerebral ischemia and infarct, which was caused by alterations of cerebral hemodynamics associated various factors including vasospasm. To improve the treatment of SAH, we investigated the risk factors associated with occurrence of DIND by use of clinical analysis. Methods we had retrospectively studied the medical records, radiographic files and data of hemodynamics and haemostatic appearance in 118 patients with aneurysmal subarachnoid hemorrhage. With these data, a multivariate logistic regression procedure was used to identify factors predictive of DIND. The prognostic ability of this regression model was evaluated with the ROC curve. Results The logistic regression demonstrated that cerebral vasospasm (OR 4.028, 95% CI 1.532 to 10.591), hydrocephalus (OR 18.564, 95% CI 1.518 to 226.986), elevated plasma osmotic pressure (OR 1.072, 95% CI 1.003 to1.145) and hyperglycemia (OR 1.064, 95% CI 1.009 to 1.085) were significantly contributed to occurrence of DIND after SAH, while the mean arterial pressure (OR 0.917, 95% CI 0.086 to 0.977) was a protective factor to reduced the occurrence of DIND. Sex, age, Hunt-Hess classification and hemostatic parameter were not related to occurrence of DIND. Conclusion The occurrence of DIND was increased with severe degree of cerebral vasospasm, incorporation of hydrocephalus, increasing of plasma osmotic pressure and hyperglycemia on admission in SAH patients. The elevation of mean arterial pressure can reduce the occurrence risk of DIND.