Factors related to cerebral vasospasm in 88 patients with aneurysmal subarachnoid hemorrhage A historical cohort study

Abstract

Objective To investigate the risk factors related to cerebral vasospasm in patients with aneurysmal subarachnoid hemorrhage （aSAH）. Methods The risk factors related to cerebral vasospasm in 88 patients with aSAH were identified through the multivariate logistic regression analysis and Cox analysis, including demographic factors, healthy habits, past medical history, acute stress factors, acute complications, acute evaluation indexes, treatment time, therapeutic measures, and hemorrhage involving brain regions. Results Drinking history （OR= 1. 077, 95% CI 1. 015-1. 142; P =0. 014） was an independent risk factor for cerebral vasospasm before admission. Histories of smoking （RR = 1. 031, 95% CI 1. 001-1. 063; P = 0. 042）, diabetes mellitus （RR = 1. 333, 95% CI 1. 100-1. 614; P =0. 003） and hypertension （RR=1. 066, 95% CI 1. 008-1. 127; P =0. 024） were the independent risk factors for cerebral vasospasm during hospitalization. The increased leukocyte count （RR = 1.117, 95% CI 1. 039- 1. 200; P = 0. 003 ） was a predictive factor for cerebral vasospasm; the administration of Nimotop （RR =0. 990, 95% CI 0. 979-1. 001; P =0. 088） significantly decreased the risk of cerebral vasospasm; the blood glucose levels in acute stage were not associated with the occurrence of cerebral vasospasm （RR = 1. 076, 95% CI 0. 968-1. 196; P =0. 175）; there was no significant difference between endovascular embolization group and surgical clipping group in the risk of cerebral vasospasm （RR = 0.792, 95% CI 0.322-1.950; P = 0.612）. Conclusions The risk of cerebral vasospasm increased significantly in patients with aSAH who have the histories of long-term drinking, smoking, diabetes mellitus, hypertension as well as increased leukocyte count, The administration of Nimotop may significantly decrease the risk of cerebral vasospasm. Key words: subarachnoid hemorrhage; intracranial aneurysms; cerebral vasospasm; nimodipine; risk factors