The Analysis Correlation Factor Before Surgery For The Prognostic Affect Of Intracranial Aneurysms

Objective:To observe some factors which may influence the prognosis of patients with intracranial aneurysms,so as to guide clinical treatment.Methods:Retrospective analysis 306 intracranial aneurysms document of neurosurgery from January 2001 to December 2007.All patients clinical grade according to Hunt-Hess,Fisher classification was assessed at admission.Evaluation was made by Glasgow outcome scale at the discharge.Then we divided 306 patients into five grades according to GOS,and observed the influence of age,hypertension,Fisher'scale,Hunt-Hess scale,surgical time and hydrocephalus to prognosis.Results:(1)We analysis the data with Logistic regression analysis(stepwise regression). Age is not selected.(2)The patients with hypertension got worse outcomes and high rate of suffering from fatality ratio after operation 22.86%(16/70),unfavourable prognosis ratio 34.29 %(24/70).The patients with unhypertension fatality ratio after operation7.20%(17/236), unfavourable prognosis ratio 13.14%(31/236).B=-1.027,P=0.005,OR=0.358.(3)According to Fisher'scale,of 165 patients who were devided intoⅠandⅡgrade,27 cases got cerebral vasospasm;of 141 patients who were devided intoⅢandⅣgrade,56 cases got cerebral vasospasm,.This finding display:lower Fisher'scale,better outcomes.B=-1.041,P=0.004, OR=0.353.(4) The patients with hydrocephaly got worse outcomes(B=-1.523,P=0.001, OR=0.218).(5) There are 227 cases whose Hunt-Hess scale wereⅠ～Ⅱgrade,68cases wereⅢgrade,11 cases wereⅣ～Ⅴgrade.B=-1.296,P=0.000,OR=0.274.The patients whose Hunt-Hess scale wereⅣ～Ⅴgrades favourable prognosis ratio were 0.274 to theⅢgrades.TheⅢgrades were 0.274 to theⅠ～Ⅱgrades.TheⅣ～Ⅴgrades were 0.075 to theⅠ～Ⅱgrades.The early surgery group contrast to the intermediate surgery group,P=0.002,P＜0.017.The early surgery group contrast to the late surgery group,P=0.025,P＞0.017.The intermediate surgery group contrast to the late surgery group,P=0.002,P＜0.017.Conclusions:Age isn't risk factor for the prognosis of surgery for intracranial aneurysm patients.The effective influencing factors conclude:hypertension,high grade of Fisher'scale,high grade of Hunt-Hess scale,and hydrocephalus.Choosing surgical time depended on Hunt-Hess scale is also important.The prognosis was better in early surgery group and late surgery group, than in intermediate surgery group.