Alemán-Rivera A, Camacho-Gómez A
Servicio de Neurocirugía. Hospital Universitario Arnaldo Milián Castro. Santa Clara, Villa Clara, Cuba.
Rev Neurol. 2001;32(12):1128-31.
Rupture of intracranial aneurysms causes nearly 80% of all spontaneous subarachnoid haemorrhages.
To determine the variables with prognostic value in view of the results of patients operated on for intracranial aneurysms. Patients and methods. The sample was made up of 100 patients from whose clinical histories useful data was obtained. This data was then fed into a database using DBASE111 and discriminant analysis made to determine the variables of predictive value regarding mortality.
The average age was 45 years, with a predominance of women. Arterial hypertension was observed in 52.9% of the patients. The patients with the best pre operative evaluation on the WFNS scale obtained the best results. Correct evaluation of 97% of the cases was done on discriminant analysis of certain variables studied. Excellent results were obtained by 75% of the patients, 10% had a slight degree of disability, four patients had severe disability and 11 patients died, five of them of non neurological conditions.
The application of discriminant analysis made it possible to determine amongst over 50 variables studied, a group which by themselves lead to the definite classification of our patients regarding survival. These were: the state of the brain during operation, number of post operative complications, difficulty in dissecting the sac of the aneurysm, early rupture of the aneurysm, pre operative neurological state and action on the aneurysm.
颅内动脉瘤破裂导致近80%的自发性蛛网膜下腔出血。
根据颅内动脉瘤手术患者的结果确定具有预后价值的变量。患者与方法。样本由100名患者组成,从其临床病史中获取了有用数据。然后使用DBASE111将这些数据输入数据库,并进行判别分析以确定与死亡率相关的预测价值变量。
平均年龄为45岁,女性居多。52.9%的患者患有动脉高血压。在WFNS量表上术前评估最佳的患者取得了最佳结果。对所研究的某些变量进行判别分析,对97%的病例进行了正确评估。75%的患者取得了优异结果,10%有轻度残疾,4例患者有严重残疾,11例患者死亡,其中5例死于非神经系统疾病。
判别分析的应用使得在所研究的50多个变量中能够确定一组变量,这些变量本身就能明确我们患者的生存分类。这些变量包括:手术时的脑状态、术后并发症数量、动脉瘤囊解剖难度、动脉瘤早期破裂、术前神经状态以及对动脉瘤采取的措施。