Analysis of risk factors of shunt dependent hydrocephalus in patients with aneurysmal subarachnoid hemorrhage
Objective To analyze the risk factors of secondary shunt dependent hydrocephalus(SDHC)in patients with aneurysmal subarachnoid hemorrhage(aSAH).Methods This study included 125 hospitalized patients admitted to the First Affiliated Hospital of Zhengzhou University with the diagnosis of aSAH between January 2022 to December 2022,including 40 patients with SDHC and 85 patients in the control group.The clinical data of the two groups were com-pared,the risk factors were analyzed by multi-factor logistic regression,and AUCs were calculated by ROC curve.Results Patients with SDHC were older,had lower GCS score at admission,and had higher modified Fisher grade and Hunt-Hess grade.There were statistically significant correlations between systemic inflammatory response syndrome and intraventricular hemorrhage,symptomatic vasospasm and secondary intracranial infection,higher leukocyte level,higher blood glucose level and higher D-dimer level with SDHC(P＜0.05).Multivariate logistic regression analysis showed intraventricular hemorrhage(OR=92.335,95％CI:6.304-1 352.366),symptomatic vasospasm(OR=15.388,95％CI:1.188-199.323)and elevated blood glucose(OR=1.411,95％CI:1.018-1.956)was an independent risk factor for SDCH in patients.ROC curve analysis showed that the AUC was 0.834(95％CI:0.747-0.921,P＜0.001),and the sensitivity was 75％.Symptomatic vasospasm AUC was 0.657(95％CI:0.546-0.768,P=0.005)and sensitivity was 35％;AUC was 0.788,95％CI:0.704-0.873,P＜0.001),sensitivity was 70％.Conclusion Intraventricular hemorrhage,symptomatic vasospasm and elevated blood glucose are independent risk factors for SDHC,and the sensitiv-ity of Intraventricular hemorrhage is higher.
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