Related Factors And Prognostic Analysis Of Tracheotumy In Surgical Patients With Aneurysmal Subarachnoid Hemorrhage

Objective: To find out related factors of tracheotomy in aneurysmal subarachnoid hemorrhage and prognostic,and provide reference for early prediction of tracheotomy.Methods: A total of 697 a SAH patients who underwent surgery or intervention between 2013 and 2016 were reviewed in neurosurgery department of a large teaching hospital.Included variables were recorded: gender,age,patient source,GCS score,HH score,WFNS score,Fisher score,treatment,onset to admission time and to operative time,hypertension,diabetes,aneurysm location,number of aneurysms,respiratory complications,ICU length of stay,hospital length of stay and mortality.Independent risk factors associated to tracheotomy were selected by multivariate logistic regression modeling from those significant different variables through univariate analysis by chi-square test and independent sample T test,or Wilcoxon test if the data were non-normal distribution.Results: 65 tracheotomy cases were found which the incidence rate was 9.3%.10 variables were found related to tracheotomy by univariate analysis: age,GCS score,HH score,WFNS score,Fisher score,hypertension,aneurysm location,respiratory complications,ICU length of stay,hospital length of stay.3 variables were found as independent risk factors associated to tracheotomy by multivariate logistic regression modeling which in ranked descendantly by OR values: respiratory complications(OR=257.335,95%CI:48.508―1365.155),hospital length of stay(OR=27.118,95%CI:6.810―107.983),age(OR=5.399,95%CI:1.705―17.097).In addition,ICU length of stay(OR=3.315,95%CI:0.949-11.574,P=0.06),also can be considered an independent risk factor.The overall mortality rate of patients with aneurysmal subarachnoid hemorrhage was 6.9%,the mortality in tracheotomy group vs the untracheotomy group:32.3% vs 4.3%,P<0.000.Conclusions: The incidence of tracheotomy in a SAH was associated to multi-factors: age,GCS score,HH score,WFNS score,Fisher score,hypertension,aneurysm location,respiratory complications,ICU length of stay,hospital length of stay.The independent risk factors were respiratory complications,hospital length of stay,and age.Early tracheotomy does not increase the mortality of patients with aneurysmal subarachnoid hemorrhage,tracheotomy should be performed as early as necessary.