Analysis of risk factors for perioperative infection of intracranial aneurysm interventional embolization for subarachnoid hemorrhage / 国际外科学杂志

ABSTRACT

Objective:To explore the risk factors of intracranial aneurysm interventional embolization for subarachnoid hemorrhage (SAH) perioperative infection.Methods:A retrospective analysis of the clinical data of 236 SAH patients who underwent aneurysm interventional embolization in the Department of Neurosurgery, Huangshan Shoukang Hospital from May 2018 to December 2019, and statistics of the surgical treatment effects and postoperative conditions of all patients, according to the perioperative Infective status in the early stage, the patients were divided into infected group ( n=44) and non-infected group ( n=192) according to the perioperative infection, and the clinical indicators of the patients were recorded, including age, gender, history of drinking, smoking history, history of diabetes, and whether there was any temporary blockade during the operation, aneurysm location, triacylglycerol, lipoprotein type, CT-Fisher classification, history of hypertension, aneurysm diameter, number, albumin, Hunt-Hess classification, Glasgow coma score (GCS) at admission, number of punctures. Measurement data were expressed as the mean ± standard deviation ( Mean± SD), comparison between groups was by t-test; count data comparison between groups was by Chi-square test. Logistic regression was used to analyze the risk factors of infection in SAH patients during perioperative period. Results:The treatment success rate of all SAH patients was 100%; the results of univariate analysis showed that the history of hypertension, aneurysm diameter, number, albumin, Hunt-Hess classification, GCS score at admission, and number of punctures were compared between infected group and non-infected group, the difference was statistically significant ( P<0.05); the results of multivariate Logistic regression analysis showed that history of hypertension, aneurysm diameter ≥8 mm, a large number of aneurysms, albumin ≤35.12 g/L, Hunt-Hess classification Grade Ⅲ to Ⅳ, GCS score> 5 points at admission, and number of punctures>2 times were risk factors for perioperative infection in SAH treated by interventional embolization of intracranial aneurysm; the total score of all factors in the nomogram prediction model was 314.84 points, the corresponding value was 14.96% of the perioperative infection rate of intracranial aneurysm interventional embolization for SAH. Conclusions:Interventional embolization of intracranial aneurysm for SAH can achieve good clinical results. However, history of hypertension, aneurysm diameter ≥ 8 mm, a large number of aneurysms, albumin ≤ 35.12 g/L, Hunt-Hess grade Ⅲ to Ⅳ, GCS score > 5 points at admission, number of punctures> 2 times are all independent risk factors leading to perioperative infection in patients, and clinical attention should be paid to and actively prevented.