Combination of Albumin/Fibrinogen Ratio and Admission Hunt-Hess Scale Score as an Independent Predictor of Clinical Outcome in Aneurysmal Subarachnoid Hemorrhage.

BACKGROUND: The albumin/fibrinogen ratio (AFR) is an independent predictor of clinical outcomes of some diseases; however, the prognostic value of AFR and the admission Hunt-Hess (HH) score is still unclear for patients with an aneurysmal subarachnoid hemorrhage (aSAH). This study aimed to assess the relationship between the AFR-HH score and 6-month outcomes of aSAH patients. METHODS: The clinical characteristics of aSAH patients admitted to our department between December 2017 and December 2021 were retrospectively analyzed. The candidate risk factors were screened using univariate regression analysis, and the independence of the resultant risk factors was evaluated by binary logistic regression analysis. The predictive value of the combined AFR and HH score for unfavorable outcomes was assessed using receiver operating characteristic curve analysis. RESULTS: A total of 112 aSAH patients were included. Binary logistic regression analysis showed the perioperative period AFR, Glasgow coma scale score, and admission HH score were independent risk factors for unfavorable outcomes for aSAH patients. The receiver operating characteristic curve analysis showed the predictive capacity of AFR plus the admission HH score outperformed the AFR, Glasgow coma scale score, and admission HH scale alone and the combination of the AFR and Glasgow coma scale score. CONCLUSIONS: A low AFR during the perioperative period is associated with unfavorable outcomes for aSAH patients at 6 months. The combination of the AFR and admission HH scale score provides superior predictive capacity to either the AFR or HH scale score alone.

[Risk factors of portal vein thrombosis after surgery for advanced schistosomiasis portal hypertension].

OBJECTIVE: To explore the risk factors of portal vein thrombosis (PVT) after splenectomy and esophagogastric devascularization for advanced schistosomiasis portal hypertension. METHODS: The clinical data were collected retrospectively from 211 advanced schistosomiasis portal hypertension patients after splenectomy and esophagogastric devascularization from August, 2004 to March 2014, and all the data were analyzed statistically for the risk factors of PVT after the surgery by single factor analysis and Logistic regression analysis. RESULTS: Totally 59 patients were found with PVT and the incidence was 27.96% (59/211). The single factor analysis showed that 8 factors were related to PVT after surgery, including the history of upper gastrointestinal hemorrhage, the diameter of portal vein, the diameter of splenic vein, esophageal varices, ascites, portal hypertension gastropathy, gastric varices , and blood ammonia level. The Logistic regression analysis showed that the independent risk factors of PVT were broadening of the diameter of portal vein (OR = 1.763 , P = 0.000) and portal hypertension gastropathy (OR = 1.089, P = 0.037). CONCLUSIONS: The incidence of PVT after surgery for advanced schistosomiasis is high, and the independent risk factors are broadening of diameter of portal vein and portal hypertension gastropathy.