Preoperative Predictors and Prognosticators After Microsurgical Clipping of Poor-Grade Subarachnoid Hemorrhage: A Retrospective Study.

摘要: Background Contrary to expectations, some patients with poor-grade subarachnoid hemorrhage (SAH) show favorable outcomes. However, the factors predictive of good prognosis are unclear. The purposes this study were identify related SAH and analyze preoperative prognostic factors. Methods We included 186 who underwent surgical clipping or conservative treatment immediately after diagnosis. Physiologic, radiographic, blood examination data collected retrospectively. Factors poor World Federation Neurological Societies (WFNS) grade (WFNS IV V) outcome (modified Rankin Scale scores 3–6) analyzed. Results (mean age, 61.6 years) 134 women (72%). Seventy (38.2%) had WFNS scores. On multivariate analysis, age ≥70 years (adjusted odds ratio [OR], 3.73), midline shift (OR, 4.89), absence cerebrospinal fluid in high-convexity cortical sulci 5.47) ambient cistern 4.83) Age 8.36), 5 15.35), intracerebral hematoma 3.32), Evans index (EI) ≥0.3 4.40) outcome. Body mass 0.87), intraventricular 3.86), glycated hemoglobin level 2.78), 4.12) EI ≥0.3. Conclusions Poor outcomes correlated older brain-destructive hemorrhage, reflects both hydrocephalus patient's frailty. Radiographic signs not outcome, suggesting that early decompressive surgery may improve