{"title":"Predictive Factors for Postoperative Cerebrospinal Fluid Drainage in Neurosurgical Management of Intracranial Aneurysms.","authors":"Xiaohong Guo","doi":"10.1016/j.wneu.2025.123913","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Management of intracranial aneurysms often requires complex neurosurgical interventions, with some patients necessitating postoperative cerebrospinal fluid (CSF) drainage. Identifying predictive factors for CSF drainage can enhance patient outcomes through targeted interventions and improved perioperative care.</p><p><strong>Methods: </strong>In this retrospective study, 151 patients who underwent surgical treatment for intracranial aneurysms were included. Demographic data, clinical presentation (Hunt-Hess grade, modified Fisher score), surgical details (operative time, intraoperative complications), and postoperative outcomes were reviewed. Both univariate and multivariable logistic regressions were conducted to identify predictors of postoperative CSF drainage. A subgroup analysis compared patients with anterior versus posterior circulation aneurysms.</p><p><strong>Results: </strong>Overall, 67 patients required postoperative CSF drainage. On multivariable analysis, age ≥60, high Hunt-Hess grade, operative time >5 hours, and intraoperative aneurysm rupture significantly increased the odds of drainage (P<0.05). Subgroup analysis revealed that these risk factors conferred an even higher likelihood of CSF drainage in posterior circulation aneurysms. Gender and modified Fisher score did not show significant associations with drainage.</p><p><strong>Conclusions: </strong>Advanced age, high Hunt-Hess grade, prolonged operative time, and intraoperative rupture predict postoperative CSF drainage in patients with intracranial aneurysms. Incorporating both global and subgroup-based risk assessments can help refine perioperative strategies to reduce complications and improve patient outcomes.</p>","PeriodicalId":23906,"journal":{"name":"World neurosurgery","volume":" ","pages":"123913"},"PeriodicalIF":1.9000,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"World neurosurgery","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1016/j.wneu.2025.123913","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"CLINICAL NEUROLOGY","Score":null,"Total":0}
引用次数: 0
Abstract
Background: Management of intracranial aneurysms often requires complex neurosurgical interventions, with some patients necessitating postoperative cerebrospinal fluid (CSF) drainage. Identifying predictive factors for CSF drainage can enhance patient outcomes through targeted interventions and improved perioperative care.
Methods: In this retrospective study, 151 patients who underwent surgical treatment for intracranial aneurysms were included. Demographic data, clinical presentation (Hunt-Hess grade, modified Fisher score), surgical details (operative time, intraoperative complications), and postoperative outcomes were reviewed. Both univariate and multivariable logistic regressions were conducted to identify predictors of postoperative CSF drainage. A subgroup analysis compared patients with anterior versus posterior circulation aneurysms.
Results: Overall, 67 patients required postoperative CSF drainage. On multivariable analysis, age ≥60, high Hunt-Hess grade, operative time >5 hours, and intraoperative aneurysm rupture significantly increased the odds of drainage (P<0.05). Subgroup analysis revealed that these risk factors conferred an even higher likelihood of CSF drainage in posterior circulation aneurysms. Gender and modified Fisher score did not show significant associations with drainage.
Conclusions: Advanced age, high Hunt-Hess grade, prolonged operative time, and intraoperative rupture predict postoperative CSF drainage in patients with intracranial aneurysms. Incorporating both global and subgroup-based risk assessments can help refine perioperative strategies to reduce complications and improve patient outcomes.
期刊介绍:
World Neurosurgery has an open access mirror journal World Neurosurgery: X, sharing the same aims and scope, editorial team, submission system and rigorous peer review.
The journal''s mission is to:
-To provide a first-class international forum and a 2-way conduit for dialogue that is relevant to neurosurgeons and providers who care for neurosurgery patients. The categories of the exchanged information include clinical and basic science, as well as global information that provide social, political, educational, economic, cultural or societal insights and knowledge that are of significance and relevance to worldwide neurosurgery patient care.
-To act as a primary intellectual catalyst for the stimulation of creativity, the creation of new knowledge, and the enhancement of quality neurosurgical care worldwide.
-To provide a forum for communication that enriches the lives of all neurosurgeons and their colleagues; and, in so doing, enriches the lives of their patients.
Topics to be addressed in World Neurosurgery include: EDUCATION, ECONOMICS, RESEARCH, POLITICS, HISTORY, CULTURE, CLINICAL SCIENCE, LABORATORY SCIENCE, TECHNOLOGY, OPERATIVE TECHNIQUES, CLINICAL IMAGES, VIDEOS