Clinical analysis of rebleeding of ruptured aneurysms during the hospitalization
10.3969/j.issn.1672-5921.2010.07.001
- Author:
Hong-Yu ZHOU
1
Author Information
1. Department of Neurosurgery
- Publication Type:Journal Article
- Keywords:
Aneurysm;
Interventional studies;
Intracranial aneurysm;
Intracranial hemorrhages;
Ruptured;
Subarachnoid hemorrhage
- From:
Chinese Journal of Cerebrovascular Diseases
2010;7(7):337-343
- CountryChina
- Language:Chinese
-
Abstract:
Objective: To investigate the time of rebleeding, the related risk factors and the prognosis of rebleeding in patients with ruptured intracranial aneurysms during the hospitalization. Methods: The clinical data of 253 hospitalized patients with ruptured intracranial aneurysms were analyzed retrospectively. They were divided into an early intervention (0 to 3 days) group (154 patients) and late intervention (4 to 28 days) groups (99 patients) according to the time of surgical or endovascular treatment. And then they were redivided into two subgroups according to whether they had rebleeding or not. Statistical methods were used to analyze the relationship between rebleeding and sex, age of the patients, site and size of the aneurysms, CT findings, Hunt-Hess grade, complicating hypertension, and the Glasgow Outcome Score (COS). Results: Circled digit one Of the 253 patients with ruptured intracranial aneurysms, 26 patients had rebleeding. The overall rebleeding rate was 10.3% (26/253) during hospitalization, 5. 2% (8/154) in the early intervention group and 18.2% (18/99) in the late intervention group; The median time between the first and to rebleeding was 6.5 days. Circled digit two There were significant differences in age and whether complicating hypertension or not between the patients with rebleeding and non-rebleeding in the early intervention group (P < 0.05). There were no significant differences in age and whether complicating hypertension or not between the patients with rebleeding and non-rebleeding in the late intervention group (P > 0.05). Circled digit three There were no significant differences in patients sex and age, site and size of aneurysm, CT findings, and Hunt-Hess grade between the early intervention and late intervention groups in patients with rebleeding and non-rebleeding (P > 0.05). Circled digit four There were significant differences in GOS among the whole group of patients, early intervention and late intervention groups, in patients with or without rebleeding (P < 0.05). The GOS in patients with rebleeding was significantly lower than that in patients with non-rebleeding. Circled digit five The mortality rate of rebleeding in the whole group was 13.8% (35/253), of those, 10.1% (23/227) was in the non-bleeding group, and 46.2% (12/26) was in the bleeding group. There was significant difference between the two groups (χ2 = 25.499, P < 0.05). The mortality rate of rebleeding was 62.5% (5/8) in the early intervention group, and 38.9% (7/18) in the late intervention group; however, there was no significant difference between the two groups (χ2 = 1.242, P > 0.05). Conclusions: Circled digit one The rebleeding rate of the ruptured aneurysms in the late intervention group was significantly higher than that in the early intervention group, and it is indicated that early surgery or endovascular treatment could reduce the incidence of rebleeding; Circled digit two the early rebleeding was associated with the age of patients and complicating hypertension; the advanced age and complicating hypertension were the risk factors for early rebleeding, while the late rebleeding was not significantly associated with the age of patients and complicating hypertension; Circled digit three There were no significant correlation between the rebleeding of ruptured aneurysms and sex, site and size of aneurysm, CT findings, and Hunt-Hess grade of the patients; Circled digit four the rebleeding of ruptured aneurysms markedly increased the mortality rate of patients.
