Short-term Prognostic Factors Analysis In Minimally Invasive Surgery Of Hypertensive Intracerebral Hemorrhage

Objective: Clinical value of hypertensive cerebral hemorrhage minimally invasive puncture treatment and the relationship between influential factors and short-term prognosis of that is discussed, in order to improve patient outcomes and reduce dependence on society.Methods: This study references to previous literature. A total of 117 cases of validated HICH were identified during the study period, which is retrospective analyzed. This study chose the following variables as prognostic factors: age, history of hypertension, preoperative systolic blood pressure,preoperative blood glucose, preoperative GCS score, hemorrhage position,shape of hematoma, hematoma volume, timing of surgery, intraventricular hemorrhage, midline shift, rebreeding, reoperation, lung infections, electrolyte imbalance. Activity of daily living(ADL) is selected to grade prognostic criteria of the patients after 30 days. Chi-square test was used in univariate analysis to analyze whether each influencing factor which is statistically significant. Then statistically significant factors were inducted into multiple logistic regression models to analyze their correlations with prognosis.Results:(1) The study included 117 cases of whom 40(34%) were female and 77(66%) were male. The mean age of the cohort in the study was 56.95±12.09 years(range, 30-83 years). The mean history of hypertension of the cohort in the study was 7.11±5.61 years(range, 1-30 years). The mean preoperative systolic blood pressure of the cohort in the study was 117.66±26.36 mm Hg(range, 117-248 mm Hg). The mean preoperative GCS score of the cohort in the study was 11.03±2.03 score(range, 4-14 score). The mean volume of hemorrhage of the cohort in the study was 42.12±12.5 ml(range, 21-73ml). The mean timing of surgery of the cohort in the study was 31.23±15.15 hours(range, 3-144 hours). The mean ranging in preoperative blood glucose of the cohort in the study was 7.38±2.23 mmol/L(range, 3.8-15.2 mmol/L).Among 117 patients with cerebral hemorrhage, had 74 basal ganglia, had 29 brain lobes, had 8 thalamus and 6 cases of other types. There were 51 lung infections、6 electrolyte disorder、48 cases of good and 69 cases of poor with prognosis.(2) Data within clinical experience were analyzed using Chi-square test and P<0.05 was considered statistically significant. According to univariate analysis age, preoperative systolic blood pressure, preoperative blood glucose, preoperative GCS score, hemorrhage position,hematoma volume, timing of surgery, intraventricular hemorrhage, midline shift, rebleeding, reoperation, lung infections were statistically significant and related to the prognosis of patients(P=0.009、P= 0.043、P=0.011 、 P= 0.002 、 P=0.011 、 P < 0.001 、 P=0.007 、 P<0.001 、 P<0.001 、 P=0.037 、 P=0.010 、P<0.001,respectively).(3) Multivariate analysis of the statistically significant factors was performed logistic regression model, An independent risk factor for poor prognosis include age(OR=4.153,95%CI:1.346 ~ 12.815, P=0.013),preoperative blood glucose(OR=4.813, 95%CI:1.181 ~19.768,P=0.028), preoperative GCS score(OR=0.112,95%CI:0.150~0.885, P=0.035),hematoma volume(OR=5.113,95%CI:1.170~22.338,P=0.030),intraventricular hemorrhage(OR=0.075, 95%CI:0.006~0.955,P=0.046),reoperation(OR=0.052,95%CI: 0.003~0.951, P=0.046),lung Infections(OR=0.192,95%CI:0.051~0.723, P=0.015).Conclusions: HICH minimally invasive puncture treatment is a minimally invasive, simple and effective operation. Take all the data into consideration, many factors influence the prognosis of HICH patients after surgical operation, but the key factors include age, preoperative blood glucose, preoperative GCS score,hematoma volume, intraventricular hemorrhage, reoperation, lung infections. These factors can be used as prognostic evaluation of patients with cerebral hemorrhage after minimally invasive surgery. Thus,treatment and prevention towards these factors should be emphasized in clinic to improve patient’s the cure rate and to reduce mortality.