Analysis of factors influencing the short-term survival in patients with aneurysmal subarach-noid hemorrhage
Objective To investigate the factors associated with short-term survival in patients with aneurysmal subarachnoid hemorrhage(aSAH).Methods The clinical data of 407 patients with aS AH treated by the Department of Neurosurgery of Weifang People's Hospital from June 2019 to March 2022 were retrospectively analyzed,including patients'clinical data,imaging data and survival outcomes.The log-rank test was used for univariate analysis of survival outcome of aSAH patients,and variables with P＜0.05 were included in the multivariate Cox proportional risk regression model for multivariate analysis of survival.Results The follow-up time[median(Q,,Q3)]for 407 patients was 9.2(6.5,18.7)months.By the final follow-up,there were 121 deaths(29.7％).The results of univariate analysis showed that patients who were males,≥60 years of age,had a history of smoking,alcohol consumption,history of primary hypertension,history of ischemic stroke,Glasgow Coma Score(GCS)on admission of 3-8,Hunt-Hess classification Ⅳ-Ⅴ,modified Fisher Scale score of 3-4,concomitant cerebral vasospasm,and concomitant pulmonary infections had lower survival rate,and those with aneurysms that were saccular and treated with endovascular embolization had higher survival rate,and the differences were statistically significant(all P＜0.05).Analysis of the multivariate Cox proportional risk regression model showed that age ≥60 years(HR=2.14,95％CI:1.44-3.19,P＜0.001),history of primary hypertension(HR=1.83,95％CI:1.19-2.82,P=0.006),history of ischemic stroke(HR=1.71,95％CI:1.02-2.87,P=0.043),Hunt-Hess classification Ⅳ-Ⅴ at admission(HR=2.45,95％CI:1.25-4.79,P=0.009),modified Fisher Scale score of 3-4(HR=1.80,95％CI:1.11-2.90,P=0.017),and concurrent cerebral vasospasm(HR=2.59,95％CI:1.58-4.25,P＜0.001),and concomitant pulmonary infection(HR=1.72,95％CI:1.02-2.90,P=0.042)were all risk factors affecting patients'short-term survival,whereas a GCS score of 13-15(HR=0.48,95％CI:0.25-0.93,P=0.030)and endovascular embolization therapy(HR=0.55,95％CI:0.31-0.97,P=0.039)were protective factors affecting patients'short-term survival.Conclusions Patients with aSAH who were ≥60 years of age,had a history of primary hypertension,a history of ischemic stroke,Hunt-Hess classification grades Ⅳ-Ⅴ,modified Fisher Scale score of 3-4,concomitant cerebral vasospasm and pulmonary infections have an increased risk of short-term mortality,whereas patients with aSAH who have a GCS of 13-15 points and who are treated with endovascular embolization have a relatively low risk of short-term mortality.
Intracranial aneurysmSubarachnoid hemorrhagePrognosisRoot cause analysis
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