Association between volume of intraventricular hemorrhage and outcomes in patients with ruptured cerebral aneurysms
10.3760/cma.j.issn.1671-8925.2014.03.014
- VernacularTitle:颅内动脉瘤破裂后脑室出血体积与预后的关系
- Author:
Chuan CHEN
1
;
Lun LUO
;
Hui WANG
;
Wensheng LI
;
Ying GUO
;
Feng QIN
Author Information
1. 中山大学附属第三医院神经外科
- Keywords:
Sneurysm;
Intraventricular hemorrhage;
Subarachnoid hemorrhage;
Delayed cerebral ischemia;
Outcome
- From:
Chinese Journal of Neuromedicine
2014;13(3):282-287
- CountryChina
- Language:Chinese
-
Abstract:
Objective To assess the association between volume of intraventricular hemorrhage (IVH) and outcomes in patients with ruptured cerebral aneurysms.Methods A retrospective analysis of the clinical data of patients with aneurysmal subarachnoid hemorrhage (aSAH) accompanied by IVH,admitted to our hospital from May 2007 to January 2012,was performed.The IVH scale and SAH scale systems were used to assess the IVH volume and SAH sum,and delayed cerebral ischemia (DCI) was diagnosed in accordance with correlative standard.Outcomes at 6 months of follow-up were assessed using modified Rankin Scale (mRS,good outcome:0-2; poor outcome:3-6).Univariate analyses and multiple logistic regression analyses were performed to assess the association between volume of IVH and outcomes.Results A total of 129 patients met the criteria were enrolled; 75 patients(58.1％) had a good neurological outcome; significant difference in volume of intraventricular hemorrhage was noted between patients with good and poor neurological outcomes (5.69±5.08 mL vs.12.69±12.04 mL,P＜ 0.05); the outcomes of patients with IVH in the fourth quartile were worse than those in the first quartile (OR=4.800,95％CI:1.555-14.813,P=0.005).In the multivariate analysis,the volume of intraventricular hemorrhage was an independent predictor of poor outcomes (OR=1.089,95％CI:1.012-1.173,P=0.023).A total of 48 patients (37.2％) developed DCI after ictus; univariate analyses showed that IVH volume was associated with onset of DCI (OR=1.050,95％CI:1.004-1.097,P=0.033),but multiple Logistic regression analysis denied that (OR=0.989,95％CI:0.927-1.044,P=0.693).Conclusion The volume of IVH is an independent predictor of poor outcomes in patients with aSAH; however,the pathophysiology of this association seems not to include inducing DCI.
