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首页> 外文期刊>BMC Surgery >Predictors and outcomes of shunt-dependent hydrocephalus in patients with aneurysmal sub-arachnoid hemorrhage
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Predictors and outcomes of shunt-dependent hydrocephalus in patients with aneurysmal sub-arachnoid hemorrhage

机译：动脉瘤性蛛网膜下腔出血患者分流依赖性脑积水的预测因素和转归

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Background Hydrocephalus following spontaneous aneurysmal sub-arachnoid hemorrhage (SAH) is often associated with unfavorable outcome. This study aimed to determine the potential risk factors and outcomes of shunt-dependent hydrocephalus in aneurysmal SAH patients but without hydrocephalus upon arrival at the hospital. Methods One hundred and sixty-eight aneurysmal SAH patients were evaluated. Using functional scores, those without hydrocephalus upon arrival at the hospital were compared to those already with hydrocephalus on admission, those who developed it during hospitalization, and those who did not develop it throughout their hospital stay. The Glasgow Coma Score, modified Fisher SAH grade, and World Federation of Neurosurgical Societies grade were determined at the emergency room. Therapeutic outcomes immediately after discharge and 18?months after were assessed using the Glasgow Outcome Score. Results Hydrocephalus accounted for 61.9% (104/168) of all episodes, including 82 with initial hydrocephalus on admission and 22 with subsequent hydrocephalus. Both the presence of intra-ventricular hemorrhage on admission and post-operative intra-cerebral hemorrhage were independently associated with shunt-dependent hydrocephalus in patients without hydrocephalus on admission. After a minimum 1.5?years of follow-up, the mean Glasgow outcome score was 3.33?±?1.40 for patients with shunt-dependent hydrocephalus and 4.21?±?1.19 for those without. Conclusions The presence of intra-ventricular hemorrhage, lower mean Glasgow Coma Scale score, and higher mean scores of the modified Fisher SAH and World Federation of Neurosurgical grading on admission imply risk of shunt-dependent hydrocephalus in patients without initial hydrocephalus. These patients have worse short- and long-term outcomes and longer hospitalization.
机译：背景自发性动脉瘤性蛛网膜下腔出血（SAH）后脑积水通常与不良预后相关。这项研究旨在确定潜在的危险因素和动脉瘤性SAH患者分流依赖性脑积水但在到达医院时无脑积水。方法对168例动脉瘤性SAH患者进行评估。使用功能评分，将那些在住院时没有脑积水的人与入院时已经患有脑积水的人，在住院期间发展为脑积水的人以及在整个住院期间未发展为脑积水的人进行比较。在急诊室确定了格拉斯哥昏迷评分，改良的Fisher SAH评分和世界神经外科学会联合会评分。使用格拉斯哥结果评分评估出院后和出院后18个月的治疗效果。结果脑积水占所有发作的61.9％（104/168），其中入院时出现初始脑积水82例，随后发生脑积水22例。入院时无脑积水的患者入院时脑室内出血的存在和术后脑内出血均与分流依赖性脑积水独立相关。经过至少1.5年的随访，分流依赖性脑积水患者的平均格拉斯哥结局评分为3.33±1.40，而无依赖脑积水的患者平均格拉斯哥结局评分为4.21±1.19。结论改良的Fisher SAH和世界神经外科联合会对入院的患者存在脑室内出血，平均格拉斯哥昏迷量表评分较低和平均评分较高，提示无初始脑积水的患者存在分流依赖性脑积水的风险。这些患者的短期和长期预后较差，住院时间更长。

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