Analysis Of The Related Factors Of Delayed Ischemic Neurological Deficit After Aneurysmal Subarachnoid Hemorrhage

Objective:Screening for risk factors associated with delayed ischemic neurological deficit(DIND)by use of retrospective analysis,and take timely measures to intervene in order to improve the therapeutic effect and prognosis of patients with aneurysmal subarachnoid hemorrhage(aSAH).Methods:Collect the clinical data of 127 patients with aneurysmal subarachnoid hemorrhage who were admitted to Department of Neurosurgery,DaYi Hospital,Shanxi Medical University from March 2014 to September 2016.Analysis the age,sex,smoking history,cerebral vasospasm,blood pressure on admission,electrocardiogram,leukocyte count,plasma D-two dimers,aneurysm location,GCS score,clinical grade,Fisher grade and other related factors retrospective,assess patients with 3 months follow-up results using the GOS score.According to the occurrence of DIND grouping,divided into DIND group and non DIND group,using SPSS22.0 statistical software,the above factors were described and statistical analysis of the influencing factors,and ultimately determine the risk factors.Results:There were 30 DIND cases in a total of 127,accounting for 23.6%,male 15 cases,female 15 cases,male and female ratio of 1:1,the minimum age was 35,the maximum age of 78 years old,with an average age of(53.47±10.76)years old.Univariate analysis showed that smoking history,cerebral vasospasm,electrocardiogram,GCS score,clinical grade and Fisher grade differences were statistically significant(P<0.05),suggesting that they may be risk factors of DIND.Further Logistic regression analysis showed that smoking history(OR=0.153,95%CI 0.050-0.466),cerebral vasospasm(OR=3.407,95%CI 1.202-9.655)and Fisher grade(OR=6.113,95%CI 2.157-17.323)were independent risk factors of DIND,meaning that patients who had a history of smoking,cerebral vasospasm and high Fisher grade were prone to DIND.After 3 months of follow-up,the results showed that there were 24 cases of death,plant survival and severe disability,while only 6 patients with mild disability and good recovery,it can be seen that the disability and mortality rate were significantly increased after DIND.Conclusions:The occurrence of DIND after aneurysmal subarachnoid hemorrhage is the result of multiple factors;patients who had a history of smoking,cerebral vasospasm and high Fisher grade were prone to DIND;patients usually have poor prognosis after DIND and they should be controlled actively.