Di-san junyi daxue xuebao (Nov 2021)
Risk factors of chronic hydrocephalus after operation of aneurysmal subarachnoid hemorrhage
Abstract
Objective To identify the independent risk factors of chronic hydrocephalus in patients after the operation of aneurysmal subarachnoid hemorrhage (aSAH). Methods The clinical data of 99 patients with aSAH treated in our hospital from December 2014 to December 2020 were collected and retrospectively analyzed, including age, gender, history of smoking and drinking, hypertension, intraventricular hemorrhage or not, complicated with intracerebral hematoma or not, lumbar cistern drainage, ventricular drainage, intracranial infection or not, location of aneurysm, frequency of hemorrhage, and results of Fisher Grading Scale and Hunt-Hess Classification of SAH. Among the 99 cases of aSAH, 30 patients developed postoperative chronic hydrocephalus. Univariate and multivariate logistic regression analysis were performed to screen the risk factors of chronic hydrocephalus. Results The results of one-way ANOVA indicated that older age, higher Fisher grade and Hunt-Hess grade, and more bleeding times significantly increased the incidence of postoperative chronic hydrocephalus (P < 0.05); meanwhile, Chi-square test showed that intraventricular hemorrhage, intracerebral hematoma, lumbar cistern drainage, ventricular drainage, intracranial infection also resulted in elevated incidence of postoperative chronic hydrocephalus (P < 0.05). Multiple logistic regression analysis presented that intraventricular hemorrhage (P=0.003), intracerebral hematoma (P=0.005), higher Hunt-Hess grade (P=0.006), higher Fisher grade (P=0.011), ventricular drainage (P=0.005), lumbar cistern drainage (P=0.008) and intracranial infection (P=0.039) were independent risk factors of chronic hydrocephalus after aSAH operation. Conclusion Intraventricular hemorrhage, intracerebral hematoma, higher Hunt-Hess grade and Fisher grade, lumbar cistern drainage, ventricular drainage, and intracranial infection are independent risk factors of postoperative chronic hydrocephalus in patients with aSAH.
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