Predictive Factors for Postoperative Cerebrospinal Fluid Drainage in Neurosurgical Management of Intracranial Aneurysms.

IF 1.9 4区 医学 Q3 CLINICAL NEUROLOGY
Xiaohong Guo
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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.

背景:颅内动脉瘤的治疗通常需要复杂的神经外科干预,部分患者术后需要进行脑脊液(CSF)引流。确定脑脊液引流的预测因素可以通过有针对性的干预和改善围手术期护理来提高患者的预后:在这项回顾性研究中,共纳入了 151 名接受手术治疗的颅内动脉瘤患者。研究回顾了人口统计学数据、临床表现(Hunt-Hess 分级、改良费舍尔评分)、手术细节(手术时间、术中并发症)和术后结果。通过单变量和多变量逻辑回归来确定术后 CSF 引流的预测因素。一项亚组分析比较了前循环动脉瘤和后循环动脉瘤患者:共有 67 名患者需要术后 CSF 引流。多变量分析显示,年龄≥60岁、Hunt-Hess分级高、手术时间超过5小时以及术中动脉瘤破裂会显著增加引流的几率(PConclusions:高龄、Hunt-Hess分级高、手术时间长和术中破裂可预测颅内动脉瘤患者术后CSF引流情况。结合整体和亚组风险评估有助于完善围手术期策略,减少并发症并改善患者预后。
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来源期刊
World neurosurgery
World neurosurgery CLINICAL NEUROLOGY-SURGERY
CiteScore
3.90
自引率
15.00%
发文量
1765
审稿时长
47 days
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
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