Risk Management and Healthcare Policy (May 2021)
Risk Factors for Postoperative Rebleeding and Short-Term Prognosis of Spontaneous Cerebellar Hemorrhage
Abstract
Jun Shen,* Xuefei Shao,* Ruixiang Ge,* Guangfu Di, Xiaochun Jiang Department of Neurosurgery, The First Affiliated Hospital (YiJiShan Hospital) of Wannan Medical College, Wuhu City, Anhui, 241001, People’s Republic of China*These authors contributed equally to this workCorrespondence: Xiaochun JiangDepartment of Neurosurgery, The First Affiliated Hospital (YiJiShan Hospital) of Wannan Medical College, Wuhu City, Anhui, 241001, People’s Republic of ChinaTel/Fax +86 05535739595Email [email protected]: Postoperative rebleeding (PRB) is one of the most severe complications after hematoma evacuation of spontaneous intracerebral hemorrhage (ICH). PRB has been proven to be an independent risk factor for poor prognosis. Previous studies have shown that spot sign and blend sign are independent risk factors for PRB of spontaneous ICH. However, the risk factors for PRB of spontaneous cerebellar hemorrhage (SCH) have not been elucidated. The aim of the present study was to investigate the possible risk factors for PRB and short-term prognosis of patients with SCH.Patients and Methods: This study identified 62 patients with SCH who underwent hematoma evacuation in our department. Risk factors for PRB and short-term prognosis were identified by a univariable logistic regression model, and predictors with a P value of less than 0.05 were included in the multivariable logistic regression model to identify independent predictors. A receiver operating characteristic (ROC) curve was created to test the sensitivity and specificity of independent risk factors.Results: Hematoma volume was the only independent predictor of PRB (OR=15.14, 95% CI=1.08– 213.1, P=0.044). The sensitivity and specificity of hematoma volume to PRB were 63.6% and 89.7%, respectively, and the cutoff value of hematoma volume was > 29.3 mL. GCS score ≤ 8 (OR=5.131, 95% CI=1.030– 25.554, P=0.046) and PRB (OR=13.17, 95% CI=1.316– 131.798, P=0.028) were independent risk factors for poor prognosis of patients with SCH. The sensitivity and specificity of the GCS score to poor prognosis were 66.7% and 86.2%, respectively. The sensitivity and specificity of the PRB to poor prognosis were 36.4% and 96.6%, respectively.Conclusion: Hematoma volume is likely to be a strong predictor of PRB among patients with SCH. GCS scores ≤ 8 on arrival and PRB were significant predictors of short-term poor outcome.Keywords: Glasgow Coma Scale, modified Rankin Scale, postoperative rebleeding, spontaneous cerebellar hemorrhage, spontaneous intracerebral hemorrhage
