Rahmanian Abdolkarim, Derakhshan Nima, Mohsenian Sisakht Alireza, Karamzade Ziarati Najme, Raeisi Shahraki Hadi, Motamed Soheil
Department of Neurosurgery, Shiraz University of Medical Sciences, Shiraz, Iran.
Student Research Committee, Iran University of Medical Sciences, Tehran, Iran.
Bull Emerg Trauma. 2018 Apr;6(2):133-140. doi: 10.29252/beat-060215.
To evaluate the odds for unfavorable outcome of each risk factor and a combination of them in patients with aneurysmal subarachnoid hemorrhage (SAH) undergoing surgical clipping in Southern Iran.
A total of 367 patients who were operated between March 2007 and March 2016 due to aneurysmal SAH were analyzed according to patients' factors, aneurysm characteristics and intra-operative data. Correlation between outcomes of patients measured by modified Rankin Scale at 6-months with each factor were analyzed. Market Basket analysis was also used to identify the odds of unfavorable outcome for combinations of factors.
A total of 367 patients, including 199 females and 168 males with a mean age of 47.27± 11.53 years, who underwent operation between March 2007 and March 2016 due to aneurysmal SAH were analyzed. Unlike gender, higher age was associated with unfavorable outcome. Ischemic heart disease, Duration of operation and amount of bleeding were also found to increase the odds of unfavorable outcome (=0.01, 0.02, 0.04 respectively). DM, Cigarette smoking and opium addiction as well as the location and multiplicity of aneurysms did not have an adverse effect on outcome. (≥0.05).
Among the numerous risk factors presumed to result in unfavorable outcome in aneurysmal SAH, only older age, duration of operation more than 60 minutes, previous known history of ischemic heart disease, poorer clinical grade and intra-operative bleeding more than 500 mL were found to be significant factors.
评估伊朗南部接受手术夹闭治疗的动脉瘤性蛛网膜下腔出血（SAH）患者中各风险因素及其组合导致不良结局的几率。
对2007年3月至2016年3月期间因动脉瘤性SAH接受手术的367例患者，根据患者因素、动脉瘤特征和术中数据进行分析。分析6个月时改良Rankin量表测量的患者结局与各因素之间的相关性。还采用市场篮分析来确定因素组合导致不良结局的几率。
共分析了367例患者，其中199例女性和168例男性，平均年龄47.27±11.53岁，他们于2007年3月至2016年3月期间因动脉瘤性SAH接受手术。与性别不同，年龄较大与不良结局相关。还发现缺血性心脏病、手术时间和出血量也会增加不良结局的几率（分别为=0.01、0.02、0.04）。糖尿病、吸烟和鸦片成瘾以及动脉瘤的位置和多发性对结局没有不良影响（≥0.05）。
在众多被认为会导致动脉瘤性SAH不良结局的风险因素中，仅发现年龄较大、手术时间超过60分钟、既往有缺血性心脏病史、临床分级较差以及术中出血超过500 mL是显著因素。
