医学
蛛网膜下腔出血
回顾性队列研究
接收机工作特性
改良兰金量表
血管内治疗
单中心
优势比
血管内卷取
脑积水
单变量分析
逻辑回归
多元分析
动脉瘤
内科学
外科
缺血性中风
缺血
作者
Botao Wu,Zhe Huang,Huan Liu,Jun He,Yan Jiang,Ziwei Chen,Taiwei Zhang,Fuxin Yi
标识
DOI:10.3389/fneur.2022.963624
摘要
The long-term survival prognosis of patients with high-grade (Hunt-Hess grade IV-V or World Federation of Neurosurgical Societies grade IV-V) aneurysmal subarachnoid hemorrhage (aSAH) is generally poor, and the association between endovascular treatment timing and the prognosis of high-grade aSAH has not been explored in depth. This retrospective cohort study aimed to determine whether endovascular treatment within 24 h of high-grade aSAH is associated with a better prognosis.We retrospectively analyzed the clinical data of patients with high-grade aSAH who were admitted to our institution between January 2018 and January 2021. The Modified Rankin Scale score was used to assess the 6-month prognosis of patients. Univariate and multivariate logistic regression analyses were used to identify the factors associated with prognosis. The area under the receiver operating characteristic (ROC) curve was used to assess the model's discriminatory ability.Eighty-six patients were included in the study. In the multivariate analysis, the timing of endovascular treatment (odds ratio = 7.003 [1.800-27.242], P = 0.005) was an independent risk factor for prognosis. The ROC curve showed that the predictive power of the timing of endovascular treatment was 0.744, the best cut-off value was 12.5 h, and the corresponding sensitivity and specificity were 71.4 and 70.5%, respectively. Hydrocephalus (P = 0.005) and pulmonary infection (P = 0.029) were also associated with prognosis. In addition, cerebrospinal fluid drainage immediately after endovascular treatment had a significant effect on reducing hydrocephalus formation.Endovascular therapy within 24 h is feasible and improves the prognosis of patients with high-grade aSAH.
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