Analysis of risk factors for hydrocephalus after aneurysmal subarachnoid hemorrhage and construction of prediction model
Objective To analyze the risk factors of hydrocephalus after aneurysmal subarachnoid hemorrhage(aSAH)and establish a prediction model.Methods A total of 671 patients with aSAH admitted to General Hospital of Northern Theater Command from June to December 2023 were selected as the study objects.Patients were divided into hydrocephalus group and non-hydrocephalus group ac-cording to whether hydrocephalus occurred 3 months after aSAH.Multivariate difference analysis and stepwise Logistic regression were used for univariate and multivariate analysis to obtain the risk factors affecting the occurrence of hydrocephalus.The prediction model was constructed and the applicability and calibration of the model were evaluated by the area under receiver operating characteristic(ROC)curve and H-L fit test.The clinical prediction value was evaluated by clinical decision curve.Results Aneurysm location,Glasgow coma score,modified Fisher grade,external ventricular drainage and cerebrospinal fluid glucose content were independent pre-dictors of hydrocephalus after aSAH(P＜0.05).The area under ROC curve of the model was 0.826(95%confidence interval 0.781-0.869).The prediction model provided a net benefit in the decision curve analysis with a threshold probability between 0.05 and 0.65,indicating that the model could accurately predict hydrocephalus events.Conclusion Posterior circulation aneurysm,high Glas-gow coma score upon admission,modified Fisher grade 3-4,need for external ventricular drainage,and reduced cerebrospinal fluid glu-cose content are independent risk factors for the occurrence of post-aSAH hydrocephalus.The predictive model established by this method has good differentiation and calibration degree,and has high clinical predictive value.
NETL
NSTL
万方数据
