Corrections of critical closing pressure with cerebral vasospasm, delayed cerebral ischemia and outcomes in patients with aneurysmal subarachnoid hemorrhage / 国际脑血管病杂志

ABSTRACT

Objective To investigate the corrections of critical closing pressure (CrCP) with cerebral vasospasm (CVS),delayed cerebral ischemia (DCI) and outcomes in patients with aneurysmal subarachnoid hemorrhage (aSAH).Methods Patients with aSAH were retrospectively enrolled.CrCP was calculated on the basis of recorded arterial pressure and blood flow velocities at the proximal middle cerebral artery detected by transcranial Doppler.Univariate analysis and multivariable logistic regression analysis were used to identify the factors influencing CVS,DCI and poor outcome (Glasgow Outcome Scale scores 1-3).The correlations between CrCP and CVS,DCI and poor outcome was analyzed.Results A total of 104 patients with aSAH were included in the study,including 56 (53.8％) with CVS,and 36 (34.6％) with DCI.100 patients were included in the analysis of the outcome,including 47 cases of poor outcome.There were significant differences in CrCP values before and after CVS (40.2 ± 11.5 mmHg vs 33.8 ± 10.4 mmHg,1 mmHg =0.133 kPa;t =3.089,P=0.001).Multivariable logistic regression analysis showed that CrCP is the independent risk factor of CVS (odds ratio [OR] 1.149,95％ confidence interval[CI] 1.112-1.352;P =0.019),DCI (OR 13.413,95％ CI 3.458-51.710;P =0.005) and poor outcome (OR 1.832,95％ CI 1.088-3.357;P =0.042) in patients with aSAH.Conclusion Increased CrCP was independently associated with CVS,DCI,and poor outcome in patients with aSAH.