Risk factors of short-prognosis after minimally invasive surgery in elderly patients with hypertensive basal ganglia intracerebral hemorrhage / 国际外科学杂志

ABSTRACT

Objective:To investigate the short-term prognosis of elderly patients with hypertensive basal ganglia intracerebral hemorrhage after minimally invasive surgery and to analyze the risk factors.Methods:The clinical data of 96 elderly patients with hypertensive basal ganglia intracerebral hemorrhage admitted to the Department of Neurosurgery of Tongling People′s Hospital and Tongling Municipal Hospital from June 2016 to February 2021. According to the difference of prognosis, the patients were divided into good prognosis group( n=34) and poor prognosis group( n=62). The clinical data of the two groups were compared. Such as sex, age, basic disease (years of hypertension, diabetes), GCS score at admission, arterial systolic blood pressure at admission, blood glucose at admission, volume of cerebral parenchyma hemorrhage, whether there was a reexamination of head CT within 1 hour before operation, whether there was intraventricular hemorrhage, postoperative complications (pulmonary infection, intracranial infection, rebleeding), GOS score 1 month after operation.The metrological data of normal distribution were expressed by mean ± standard deviation ( ± s). Independent t test was used for comparison between groups. Chi-square test was used for comparison of counting data. Multivariate Logistic regression analysis was used to screen independent risk factors for short-term prognosis after minimally invasive surgery. Results:Among the 96 patients, Univariate analysis showed that there were significant differences in age, diabetes, admission GCS score, arterial systolic blood pressure (SBP), blood glucose at admission, head CT within 1 hour before operation, intraventricular hemorrhage, timing of operation and number of postoperative complications between the two groups. Multivariate Logistic regression analysis showed that age >75 years old( OR=4.358, 95% CI: 1.209-15.710), diabetes mellitus( OR=4.637, 95% CI: 1.793-11.990), admission GCS score≤ 8( OR=14.305, 95% CI: 2.694-75.950), blood glucose ≥10.0 mmol/L at admission( OR=3.229, 95% CI: 1.261-8.270), no reexamination of head CT within 1 hour before operation( OR=9.423, 95% CI: 1.827-48.599), intraventricular hemorrhage( OR=12.109, 95% CI: 3.336-43.961), operation time > 7 hours( OR=6.234, 95% CI: 1.986-19.570), the number of postoperative complications ≥ 2( OR=13.461, 95% CI: 3.624-49.999)were independent risk factors for short-term prognosis. Conclusions:Minimally invasive treatment of elderly hypertensive basal ganglia intracerebral hemorrhage can achieve satisfactory clinical outcomes. However, age >75 years old, diabetes, admission GCS score≤ 8, blood glucose ≥10.0 mmol/L at admission, no reexamination of head CT within 1 hour before operation, with intraventricular hemorrhage, operation time > 7 hours, the number of postoperative complications ≥ 2 are independent risk factors affecting short-term prognosis of patients. It is necessary to strengthen the perioperative management of patients, which is of great significance to improve the prognosis.