■脑血管痉挛(CVS)是aSAH患者在神经外科夹闭颅内动脉瘤后发生的常见并发症。这种并发症可导致临床恶化和预后不良。这项研究的目的是探讨在接受神经外科手术夹闭的aSAH患者中发生CVS的危险因素。为CVS开发一个列线图,并评估其性能。
■选择2018年1月至2023年1月在神经外科接受神经外科夹闭的aSAH患者作为本研究的对象。对这些患者的临床资料进行回顾性分析。采用Logistic多因素回归分析确定CVS的独立危险因素。使用R编程语言开发了CVS列线图形式的临床预测模型,随后对其性能和质量进行了评估。
■共156例aSAH患者纳入分析,包括训练集中的109名患者和验证集中的47名患者。在训练组中,27例患者(24.77%)在神经外科手术夹闭后发生CVS,而在验证队列中,15例患者(31.91%)经历了CVS。多元回归分析显示,年龄,Hcy,WBC,葡萄糖/钾比率,动脉瘤位置,和改良Fisher评分是CVS的独立危险因素。列线图在训练集(AUC=0.885)和验证集(AUC=0.906)中均表现出优异的判别性能。
■CVS是aSAH患者神经外科手术夹闭后的常见并发症,具有高度复杂的发病机制和病理生理过程。早期预测CVS是临床实践中的重大挑战。在这项研究中,年龄,Hcy,WBC,葡萄糖/钾比率,动脉瘤位置,和改良的Fisher等级成为CVS的独立危险因素。所得的列线图显示出实质性的预测值。
UNASSIGNED: Cerebral vasospasm (CVS) is a common complication that occurs after neurosurgical clipping of intracranial aneurysms in patients with aSAH. This complication can lead to clinical deterioration and a poor prognosis. The aim of this study is to explore the risk factors for CVS in aSAH patients who have undergone neurosurgical clipping, develop a nomogram for CVS, and evaluate its performance.
UNASSIGNED: Patients with aSAH who underwent neurosurgical clipping in the Department of Neurosurgery from January 2018 to January 2023 were selected as the subjects of this research. The clinical data of these patients were retrospectively analyzed. Logistic multivariate regression analysis was employed to identify the independent risk factors of CVS. A clinical prediction model in the form of a nomogram for CVS was developed using the R programming language and subsequently evaluated for its performance and quality.
UNASSIGNED: A total of 156 patients with aSAH were included in the analysis, comprising 109 patients in the training set and 47 patients in the validation set. In the training cohort, 27 patients (24.77%) developed CVS after neurosurgical clipping, while in the validation cohort, 15 patients (31.91%) experienced CVS. Multivariate regression analysis revealed that age, Hcy, WBC, glucose/potassium ratio, aneurysm location, and modified Fisher grade were independent risk factors for CVS. The nomogram exhibited excellent discriminative performance in both the training set (AUC = 0.885) and the validation set (AUC = 0.906).
UNASSIGNED: CVS was a prevalent complication following neurosurgical clipping in patients with aSAH, with a highly intricate pathogenesis and pathophysiological course. Early prediction of CVS represented a significant challenge in clinical practice. In this study, age, Hcy, WBC, glucose/potassium ratio, aneurysm location, and modified Fisher grade emerged as independent risk factors for CVS. The resulting nomogram demonstrated substantial predictive value.