Study on the correlation between ventricular drainage volume and hydrocephalus after operation of poor-grade aneurysmal subarachnoid hemorrhage in adults
Objective To investigate the effect of external ventricular drainage volume on shunt-dependent hydrocephalus(SDHC)after operation of adult poor-grade aneurysmal subarachnoid hemorrhage(PaSAH),and to determine the optimal cut-off value of drainage flow,so as to provide clinical basis for reducing the occurrence of SDHC.Methods The clinical data of 80 patients with PaSAH admitted to Department of Neurosurgery,904 Hospital of PLA Logistics Joint Support Force from October 2011 to December 2020 were analyzed retrospectively,and the follow-up time was≥1 year.Results A total of 80 patients with PaSAH were included in this study,of which 39 cases(48.8％)developed SDHC and 41 cases(51.2％)not.Compared with non-SDHC group,the average daily drainage volume in the first day,the first two days,the first 3 days after operation and the whole catheterization in the SDHC group was significantly higher than that in the non-SDHC group.The difference was statistically significant(P＜0.05).Modified Possion regression analysis showed that increased drainage volume in the first there days after operation increased the risk of SDHC.The difference was statistically significant.Receiver operating characteristic(ROC)curve analysis showed that ventricular drainage volume on the first day after surgery had a good predictive ability for SDHC after PaSAH surgery,and its area under curve(AUC)was 0.829,the best cut-off value was 208 mL,with a sensitivity of 79.4％,a specificity of 81.6％and a Joden index of 0.61.Conclusions The risk of postoperative SDHC gradually increases with the increase of drainage volume in the first 3 days after the placement of intraventricular drainage.The drainage volume of external ventricular drainage＞208 mL in the first day after operation is the best cut-off value for the increased risk of SDHC after PaSAH.
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