Risk factors affecting development of intraventricular hemorrhage in patients with aneurysmal subarachnoid hemorrhage

doi:10.3877/cma.j.issn.2095-5782.2022.04.011

Abstract

Abstract:

Objective

To identify independent risk factors for intraventricular hemorrhage development caused by ruptured aneurysm.

Methods

From January 2017 to August 2020, the clinical and imaging data of patients with aneurysmal subarachnoid hemorrhage were analyzed retrospectively. Univariate analysis and multivariate logistic regression analysis were performed to identify the risk factors for intraventricular hemorrhage from ruptured aneurysm.

Results

A total of 596 patients who met the criteria were enrolled in this study, and intraventricular hemorrhage was present in 198 patients (33.2%).Univariate analysis showed that age, history of diabetes mellitus, aneurysm size, and aneurysm located at posterior circulation were related to intraventricular hemorrhage. Multivariate logistic regression analysis showed that increasing age (OR = 1.017, 95%CI: 1.001-1.033, P = 0.037), history of diabetes mellitus (OR = 2.545, 95%CI: 1.244-5.208, P = 0.011), increasing aneurysm size (OR = 1.101, 95%CI: 1.031-1.177, P = 0.004) and location in the posterior circulation (OR = 1.863, 95%CI: 1.104-3.144, P = 0.02) were independent risk factors for intraventricular hemorrhage development due to ruptured aneurysm.

Conclusions

Higher age, history of diabetes mellitus, increasing aneurysm size and location in the posterior circulation are associated with the occurrence of aneurysmal intraventricular hemorrhage.

Key words: Aneurysm, Subarachnoid Hemorrhage, Intraventricular hemorrhage, Risk factors.

Jingfeng Li, Linbo Zhao, Heng Ni, Zhenyu Jia, Yuezhou Cao, haibian Shi, Sheng Liu. Risk factors affecting development of intraventricular hemorrhage in patients with aneurysmal subarachnoid hemorrhage[J]. Chinese Journal of Interventional Radiology(Electronic Edition), 2022, 10(04): 404-407.

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References 13

[1]	Morgan TC, Dawson J, Spengler D, et al. The modified graeb score: an enhanced tool for intraventricular hemorrhage measurement and prediction of functional outcome[J]. Stroke, 2013, 44(3): 635-641.
[2]	Mohr G, Ferguson G, Khan M, et al. Intraventricular hemorrhage from ruptured aneurysm : retrospective analysis of 91 cases[J]. J Neurosurg, 1983, 58(4): 482-487.
[3]	Kramer AH, Mikolaenko I, Deis N, et al. Intraventricular hemorrhage volume predicts poor outcomes but not delayed ischemic neurological deficits among patients with ruptured cerebral aneurysms[J]. Neurosurgery, 2010, 67(4): 1044-52.
[4]	Jabbarli R, Reinhard M, Roelz R, et al. The predictors and clinical impact of intraventricular hemorrhage in patients with aneurysmal subarachnoid hemorrhage[J]. Int J Stroke, 2016, 11(1): 68-76.
[5]	Darkwah Oppong M, Gembruch O, Herten A, et al. Intraventricular hemorrhage caused by subarachnoid hemorrhage: does the severity matter?[J]. World Neurosurgery, 2018, 111: e693-e702.
[6]	Zanaty M, Nakagawa D, Starke RM, et al. Intraventricular extension of an aneurysmal subarachnoid hemorrhage is an independent predictor of a worse functional outcome[J]. Clin Neurol Neurosurg, 2018, 170: 67-72.
[7]	Trifan G, Arshi B, Testai FD. Intraventricular hemorrhage severity as a predictor of outcome in intracerebral hemorrhage[J]. Frontiers in Neurology, 2019, 10: 217.
[8]	张国锋, 梁锐, 刘慧, 等. Graeb评分预测伴脑室出血的高分级动脉瘤性蛛网膜下腔出血患者转归[J]. 国际脑血管病杂志, 2021, 29(7): 507-513.
[9]	Rosen DS, Macdonald RL, Huo D, et al. Intraventricular hemorrhage from ruptured aneurysm: clinical characteristics, complications, and outcomes in a large, prospective, multicenter study population[J]. J Neurosurg, 2007, 107(2): 261-265.
[10]	Tun NN, Arunagirinathan G, Munshi SK, et al. Diabetes mellitus and stroke: a clinical update[J]. World J Diabetes, 2017, 8(6): 235-248.
[11]	Huang D, Refaat M, Mohammedi K, et al. Macrovascular complications in patients with diabetes and prediabetes[J]. Biomed Res Int, 2017, 2017: 7839101.
[12]	杨博文, 白卫星, 李天晓, 等. 椎-基底动脉夹层动脉瘤的临床与影像学特点分析[J]. 中华介入放射学电子杂志, 2016, 4(1): 4-8.
[13]	高峰, 王哲培, 陈腊. 开颅第四脑室血肿清除加侧脑室外引流术治疗全脑室积血30例疗效分析[J]. 浙江创伤外科, 2015, 20(2): 351-352.

因素		脑室出血(n = 198)	非脑室出血(n = 398)	P值
性别[男(%)]		131 (0.66)	70 (0.18)	0.870
年龄(±s，岁)		60.33 ± 12.38	57.60 ± 11.03	0.009
高血压[例(%)]		128 (0.65)	225 (0.57)	0.058
高血脂[例(%)]		3 (0.02)	7 (0.02)	1.000
糖尿病[例(%)]		20 (0.10)	15 (0.04)	0.002
心脏病[例(%)]		15 (0.08)	26 (0.07)	0.636
吸烟史[例(%)]		22 (0.11)	38 (0.10)	0.550
血小板(×10⁹/L)		194.00(145.75，258.00)	189.00(148.00，243.25)	0.482
凝血酶原时间(s)		12.3 (11.6，13.2)	12.2 (11.6，13.0)	0.389
活化部分凝血活酶时间(s)		29.3 (26.6，32.0)	28.55 (26.10，31.80)	0.121
纤维蛋白原(g/L)		2.66 (2.18，3.34)	2.73 (2.31，3.34)	0.302
凝血酶时间(s)		17.4 (16.00,19.32)	17.6 (16.4,19.00)	0.669
动脉瘤最大径(mm)		4.8 (3.6，6.9)	4.4 (3.3，6.1)	0.026
动脉瘤位置
	颈内动脉-后交通[例(%)]	68 (0.34)	158 (0.40)	0.182
	大脑前动脉-前交通[例(%)]	69 (0.35)	125 (0.31)	0.434
	大脑中动脉[例(%)]	30 (0.15)	78 (0.20)	0.172
	后循环[例(%)]	31 (0.17)	37 (0.09)	0.011

因素		脑室出血(n = 198)	非脑室出血(n = 398)	P值
性别[男(%)]		131 (0.66)	70 (0.18)	0.870
年龄(±s，岁)		60.33 ± 12.38	57.60 ± 11.03	0.009
高血压[例(%)]		128 (0.65)	225 (0.57)	0.058
高血脂[例(%)]		3 (0.02)	7 (0.02)	1.000
糖尿病[例(%)]		20 (0.10)	15 (0.04)	0.002
心脏病[例(%)]		15 (0.08)	26 (0.07)	0.636
吸烟史[例(%)]		22 (0.11)	38 (0.10)	0.550
血小板(×10⁹/L)		194.00(145.75，258.00)	189.00(148.00，243.25)	0.482
凝血酶原时间(s)		12.3 (11.6，13.2)	12.2 (11.6，13.0)	0.389
活化部分凝血活酶时间(s)		29.3 (26.6，32.0)	28.55 (26.10，31.80)	0.121
纤维蛋白原(g/L)		2.66 (2.18，3.34)	2.73 (2.31，3.34)	0.302
凝血酶时间(s)		17.4 (16.00,19.32)	17.6 (16.4,19.00)	0.669
动脉瘤最大径(mm)		4.8 (3.6，6.9)	4.4 (3.3，6.1)	0.026
动脉瘤位置
	颈内动脉-后交通[例(%)]	68 (0.34)	158 (0.40)	0.182
	大脑前动脉-前交通[例(%)]	69 (0.35)	125 (0.31)	0.434
	大脑中动脉[例(%)]	30 (0.15)	78 (0.20)	0.172
	后循环[例(%)]	31 (0.17)	37 (0.09)	0.011

因素	P值	OR	95%CI
年龄	0.037	1.017	1.001~1.033
高血压	0.261	1.235	0.855~1.786
糖尿病	0.011	2.545	1.244~5.208
动脉瘤最大径	0.004	1.101	1.031~1.177
后循环	0.020	1.863	1.104~3.144

因素	P值	OR	95%CI
年龄	0.037	1.017	1.001~1.033
高血压	0.261	1.235	0.855~1.786
糖尿病	0.011	2.545	1.244~5.208
动脉瘤最大径	0.004	1.101	1.031~1.177
后循环	0.020	1.863	1.104~3.144

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