Bonilha L, Marques E L, Carelli E F, Fernandes Y B, Cardoso A C, Maldaum M V, Borges G
Division of Neurosurgery, Department of Neurology, Faculty of Medical Sciences, State University of Campinas, Campinas, SP, Brazil.
Arq Neuropsiquiatr. 2001 Sep;59(3-B):676-80. doi: 10.1590/s0004-282x2001000500004.
Clinical and surgical outcome of patients with subarachnoid hemorrhage (SAH) due to ruptured aneurysm were assessed in comparison to pre-operative data and risk factors such as previous medical history, clinical presenting condition, CT findings and site of bleeding.
We evaluated 100 consecutive patients with aneurysmal SAH. Gender, color, history of hypertension, smoking habit, site and size of aneurysm, admittance and before surgery Hunt Hess scale, need for cerebro-spinal fluid shunt, presence of complications during the surgical procedure, Glasgow Outcome Scale, presence of vasospasm and of rebleeding were assessed and these data matched to outcome. For statistical analysis, we applied the chi-squared test or Fisher's test using the pondered kappa coefficient. Kruskal-Wallis test was used for comparison of continue variables. Tendency of proportion was analyzed through Cochran-Armitage test. Significance level adopted was 5%.
Patients studied were mainly white, female, without previous history of hypertension and non-smokers. Upon hospital admittance, grade 2 of Hunt-Hess scale was most frequently observed (34%), while grade 3 of Fisher scale was the most prevalent. Single aneurysms were most frequent at anterior circulation, between 12 and 24 mm. The most frequent Glasgow Outcome Scale observed was 5 (60%). Hunt Hess upon the moment of surgery and presence of complications during surgical procedure showed positive correlation with clinical outcome (p=0.00002 and p=0.001, respectively). Other variables were not significantly correlated to prognosis. Tendency of proportion was observed between Hunt-Hess scale and Fisher scale.
Among variables such as epidemiological data, previous medical history and presenting conditions of patients with ruptured aneurysms, the Hunt-Hess scale upon the moment of surgery and the presence of surgical adversities are statistically related to degree of disability.
将蛛网膜下腔出血（SAH）因动脉瘤破裂患者的临床和手术结果与术前数据以及诸如既往病史、临床症状、CT检查结果和出血部位等风险因素进行比较评估。
我们评估了100例连续性动脉瘤性SAH患者。评估了患者的性别、肤色、高血压病史、吸烟习惯、动脉瘤的部位和大小、入院时及手术前的Hunt Hess分级、脑脊液分流的必要性、手术过程中并发症的发生情况、格拉斯哥预后评分、血管痉挛和再出血的情况，并将这些数据与结果进行匹配。对于统计分析，我们使用加权kappa系数应用卡方检验或Fisher检验。采用Kruskal-Wallis检验比较连续变量。通过Cochran-Armitage检验分析比例趋势。采用的显著性水平为5%。
所研究的患者主要为白人、女性，无高血压病史且不吸烟。入院时，最常观察到的Hunt-Hess分级为2级（34%），而Fisher分级3级最为常见。单个动脉瘤在前循环最为常见，直径在12至24毫米之间。最常观察到的格拉斯哥预后评分为5分（60%）。手术时的Hunt Hess分级和手术过程中并发症的发生与临床结果呈正相关（分别为p = 0.00002和p = 0.001）。其他变量与预后无显著相关性。在Hunt-Hess分级和Fisher分级之间观察到比例趋势。
在诸如流行病学数据、动脉瘤破裂患者的既往病史和症状等变量中，手术时的Hunt-Hess分级和手术不利情况与残疾程度在统计学上相关。
