Quantitative Modeling of External Ventricular Drain Output to Predict Shunt Dependency in Aneurysmal Subarachnoid Hemorrhage: Cohort Study.

摘要: Acute hydrocephalus is a common complication of aneurysmal subarachnoid hemorrhage (aSAH); however, attempts to predict shunt-dependent chronic using clinical parameters have been equivocal. Cohort study aSAH treated with external ventricular drainage (EVD) placement at our institution, 2001–2016, via logistic regression. EVD-related included mean/total EVD output (days 0–2), days, days ≤ 5 mmHg, and wean/clamp fails. outcomes assessed ventriculoperitoneal shunt (VPS) placement, delayed cerebral ischemia (DCI), radiographic infarction (RI), symptomatic vasospasm (SV), age, grades. Two hundred ten patients underwent treatment for median 12 days (range 1–54); 85 required VPS (40%). On univariate analysis, output, total trial failures were significantly associated (p   204 ml on days 0–2 (OR 2.59, 95% CI 1.31–5.07). Multiple wean unfavorable functional outcome, after adjusting grade, 1.65, 1.10–2.47). We developed score incorporating grade (MAGE) predicting aSAH. predicted dependence in an age- grade-adjusted multivariable model. Early may be warranted MAGE score ≥ 4, particularly following 2 failed trials.