Prognostic influence factors of ruptured intracranial aneurysms under keyhole clipping / 中华神经医学杂志

ABSTRACT

Objective To investigate the changes of perioperative blood glucose in patients with ruptured intracranial aneurysms under keyhole clipping and their prognostic influence factors.Methods Totally, 147 patients with ruptured intracranial aneurysms, admitted to our hospital from July 2010 to July 2012, were selected.The changes of serum glucose on admission and at non-fasting state every day at the hospital, random blood sugar before operation and one day after the operation were analyzed;modified Rankin scale (mRS) was performed to evaluate short-term prognosis of the patients 14 day after the operation;Logistic regression analysis was used to analyze the prognostic influence factors of ruptured intracranial aneurysms under keyhole clipping.Results In the 147 patients with ruptured intracranial aneurysms, 57 (38.8％) had preoperative increased blood glucose and 99 (67.3％) had postoperative increased blood glucose;77 patients had ratio of postoperative/preoperative blood glucose＜1.2, 38 had ratio=1.2-1.5, and 32 had ratio ≥ 1.5.Seventy-eight patients had a good prognosis, while 69 patients gained a poor prognosis.As compared with the good prognosis group, the poor prognosis group had significantly larger percentage of patients with age elder than 60 or with postoperative blood glucose＞7.0 mmol/L, higher Hunt-Hess scale scores and ratio of postoperative/preoperative blood glucose, with significant differences (P＜0.05);multi-factor unconditional Logistic regression analysis indicated that age, postoperative and preoperative blood glucose ratio, postoperative blood glucose and Hunt-Hess scale scores were the independent factors of prognosis.Conclusion In patients with age＞60, Hunt-Hess scale Ⅳ or Ⅴ, postoperative blood glucose＞7.0 mmol/L and postoperative/preoperative blood glucose ratio ≥ 1.5, poor prognosis can be predictive.