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Effect of External Ventricular Drainage on Shunt-Dependent Hydrocephalus and Prognosis After Microsurgical Clipping in Patients with Poor-Grade Aneurysmal Subarachnoid Hemorrhage.
Xu, Xiaomei; Yang, Hongqiao; Wang, Xinyang; Wang, Li; Wang, Yuhai.
Afiliación
  • Xu X; Department of Neurosurgery, The 904(th) Hospital of PLA, Wuxi Clinical College of Anhui Medical University, Wuxi, China.
  • Yang H; Department of Neurosurgery, The 904(th) Hospital of PLA, Wuxi Clinical College of Anhui Medical University, Wuxi, China; Department of Neurosurgery, The Affiliated Lihuili Hospital of Ningbo University, Zhejiang, China.
  • Wang X; Department of Neurosurgery, The 904(th) Hospital of PLA, Wuxi Clinical College of Anhui Medical University, Wuxi, China; Medical College, Yangzhou University, Jiangsu, China.
  • Wang L; School of Nursing, Suzhou Medical College of Soochow University, Suzhou, China.
  • Wang Y; Department of Neurosurgery, The 904(th) Hospital of PLA, Wuxi Clinical College of Anhui Medical University, Wuxi, China. Electronic address: wangyuhai904@126.com.
World Neurosurg ; 2024 Sep 11.
Article en En | MEDLINE | ID: mdl-39270793
ABSTRACT

OBJECTIVE:

In poor-grade aneurysm subarachnoid hemorrhage (PaSAH), the use of external ventricular drainage (EVD) may be closely related to the occurrence of shunt-dependent hydrocephalus (SDHC). The purpose of this study was to investigate the effect of EVD on SDHC and prognosis after microsurgically clipping patients with PaSAH.

METHODS:

The clinical data of 99 patients with PaSAH admitted to the 904th Hospital of People's Liberation Army from October 2011 to December 2020 were analyzed retrospectively. Univariate and multivariate logistic regression analyses were used to clarify the relationship between EVD implantation and its drainage volume and SDHC after PaSAH. Receiver operating characteristic curves were plotted to compare the prognostic efficiency of different drainage volumes on SDHC. Modified Poisson regression analysis was used to determine the effect of SDHC on prognosis after PaSAH.

RESULTS:

EVD implantation increased the risk of SDHC (odds ratio = 6.715, 95% confidence interval 1.120-40.248, P = 0.037). The increased drainage volume on day 1, mean daily drainage volume within 2 days, and average within 3 days increased the risk of SDHC. EVD drainage volume on the first postoperative day has a good predictive ability for SDHC after PaSAH, with an area under the curve of 0.829 (95% confidence interval 0.731-0.928); the optimal cut-off value was 208 ml, with a sensitivity of 79.4%, a specificity of 81.6%, and a Youden index of 0.61. The occurrence of SDHC after aneurysm clipping significantly increases the risk of poor prognosis of PaSAH.

CONCLUSIONS:

EVD implantation is an independent risk factor for SDHC after PaSAH, and a large drainage volume in the first 3 days after EVD implantation is an independent risk factor for SDHC after PaSAH. The drainage volume on the first day after surgery is the best predictor of SDHC after PaSAH. SDHC after PaSAH is the strongest independent risk factor for poor prognosis and prolongs hospital stay.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: World Neurosurg Asunto de la revista: NEUROCIRURGIA Año: 2024 Tipo del documento: Article País de afiliación: China Pais de publicación: Estados Unidos
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: World Neurosurg Asunto de la revista: NEUROCIRURGIA Año: 2024 Tipo del documento: Article País de afiliación: China Pais de publicación: Estados Unidos