Risk factors of hemorrhage associated with external ventricular drainage

doi:10.3877/cma.j.issn.2095-9141.2022.03.005

Abstract

Abstract:

Objective

To investigate the risk factors of hemorrhage associated with external ventricular drainage (EVD), and to provide theoretical basis for the prevention and early diagnosis and treatment of hemorrhage associated with EVD.

Methods

A retrospective analysis was made of 114 patients with extraventricular drainage surgery admitted to Neurosurgery Department of Fuyang Cancer Hospital from January 2018 to May 2021. They were divided into bleeding group (28 cases) and non bleeding group (86 cases) according to whether they had hemorrhage associated with EVD. The baseline data of the two groups were compared, and then the factors with statistical significance in univariate analysis were included in multivariate Logistic regression analysis to explore the independent risk factors of hemorrhage associated with EVD.

Results

The results of univariate analysis showed that the age, previous stroke rate, preoperative antiplatelet drug use rate, preoperative anticoagulant drug use rate and puncture times of patients in the bleeding group were higher than those in the non bleeding group, and the concurrent brain surgery rate was lower than in the non bleeding group, with significant differences (P<0.05). The results of multivariate Logistic regression analysis showed that the use of preoperative antiplatelet drugs (OR=7.205, 95%CI:2.243-23.144) was a protective factor, while the number of punctures (OR=2.473, 95%CI: 1.315-4.650) and concurrent craniocerebral surgery (OR=0.163, 95%CI: 0.038-0.702) was a possible independent protective factor for puncture tract hemorrhage after extraventricular drainage (P<0.05).

Conclusion

Preoperative use of antiplatelet drugs is a protective factor, while the number of puncture times and simultaneous craniocerebral surgery may be independent risk factors for puncture hemorrhage after extraventricular drainage, so attention should be paid to active prevention and early intervention in clinical practice.

Key words: External ventricular drainage, Cerebral hemorrhage, Risk factors, Retrospective studies

Jun Shen, Wenqing Xu, Bin Fu, Xianghu Zheng, Jing Zhang. Risk factors of hemorrhage associated with external ventricular drainage[J]. Chinese Journal of Neurotraumatic Surgery(Electronic Edition), 2022, 08(03): 155-160.

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References 29

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项目		出血组(n=28)	未出血组(n=86)	t/χ²/Z值	P值
年龄（岁，±s）		61.75±14.60	53.71±17.83	2.161	0.033
性别[例(%)]				2.556	0.110
	男	21(75.0)	50(58.1)
	女	7(25.0)	36(41.9)
入院诊断[例(%)]				8.434	0.099
	脑出血	20(71.4)	50(58.1)	1.574	0.210
	颅脑创伤	1(3.6)	11(12.8)	1.053	0.305
	动脉瘤性蛛网膜下腔出血	4(14.3)	13(15.1)	0	1.000
	脑肿瘤	0(0.0)	9(10.5)	1.905	0.168
	脑梗死	3(10.7)	2(2.3)	1.826	0.177
	感染	0(0.0)	1(1.2)		1.000
入院GCS评分[M(P₂₅，P₇₅)]		7.25(5.25,13.00)	7.00(5.00,12.00)	-0.817	0.414
高血压[例(%)]		17(60.7)	51(59.3)	0.017	0.895
糖尿病[例(%)]		7(25.0)	14(16.3)	1.069	0.301
吸烟[例(%)]		6(21.4)	18(20.9)	0.003	0.955
饮酒[例(%)]		6(21.4)	17(19.8)	0.036	0.849
脑卒中史[例(%)]		11(39.3)	16(18.6)	4.998	0.025
术前抗血小板药物[例(%)]		11(39.3)	9(10.5)	12.129	<0.001
术前抗凝药物[例(%)]		3(10.7)	1(1.2)		0.045
脑室外引流[例(%)]		2(7.1)	17(19.8)	1.600	0.206
双侧穿刺[例(%)]		4(14.3)	14(16.3)	0.000	1.000
穿刺次数[M(P₂₅，P₇₅)]		1.00(1.00,3.00)	1.00(1.00,2.00)	-2.207	0.027
同期颅脑手术[例(%)]		3(10.7)	30(34.9)	5.999	0.014

项目		出血组(n=28)	未出血组(n=86)	t/χ²/Z值	P值
年龄（岁，±s）		61.75±14.60	53.71±17.83	2.161	0.033
性别[例(%)]				2.556	0.110
	男	21(75.0)	50(58.1)
	女	7(25.0)	36(41.9)
入院诊断[例(%)]				8.434	0.099
	脑出血	20(71.4)	50(58.1)	1.574	0.210
	颅脑创伤	1(3.6)	11(12.8)	1.053	0.305
	动脉瘤性蛛网膜下腔出血	4(14.3)	13(15.1)	0	1.000
	脑肿瘤	0(0.0)	9(10.5)	1.905	0.168
	脑梗死	3(10.7)	2(2.3)	1.826	0.177
	感染	0(0.0)	1(1.2)		1.000
入院GCS评分[M(P₂₅，P₇₅)]		7.25(5.25,13.00)	7.00(5.00,12.00)	-0.817	0.414
高血压[例(%)]		17(60.7)	51(59.3)	0.017	0.895
糖尿病[例(%)]		7(25.0)	14(16.3)	1.069	0.301
吸烟[例(%)]		6(21.4)	18(20.9)	0.003	0.955
饮酒[例(%)]		6(21.4)	17(19.8)	0.036	0.849
脑卒中史[例(%)]		11(39.3)	16(18.6)	4.998	0.025
术前抗血小板药物[例(%)]		11(39.3)	9(10.5)	12.129	<0.001
术前抗凝药物[例(%)]		3(10.7)	1(1.2)		0.045
脑室外引流[例(%)]		2(7.1)	17(19.8)	1.600	0.206
双侧穿刺[例(%)]		4(14.3)	14(16.3)	0.000	1.000
穿刺次数[M(P₂₅，P₇₅)]		1.00(1.00,3.00)	1.00(1.00,2.00)	-2.207	0.027
同期颅脑手术[例(%)]		3(10.7)	30(34.9)	5.999	0.014

因素	偏回归系数	标准误	Wald χ²值	P值	OR值	95%CI
年龄	0.812	0.128	3.816	0.925	5.933	4.661~7.022
脑卒中史	0.723	0.874	8.175	1.147	6.174	7.369~8.142
术前抗凝药物	0.857	0.632	4.326	2.456	9.175	9.962~12.374
术前抗血小板药物史	1.975	0.595	11.001	0.001	7.205	2.243~23.144
穿刺次数	0.905	0.322	7.901	0.005	2.473	1.315~4.650
同期颅脑手术	-1.811	0.744	5.929	0.015	0.163	0.038~0.702

因素	偏回归系数	标准误	Wald χ²值	P值	OR值	95%CI
年龄	0.812	0.128	3.816	0.925	5.933	4.661~7.022
脑卒中史	0.723	0.874	8.175	1.147	6.174	7.369~8.142
术前抗凝药物	0.857	0.632	4.326	2.456	9.175	9.962~12.374
术前抗血小板药物史	1.975	0.595	11.001	0.001	7.205	2.243~23.144
穿刺次数	0.905	0.322	7.901	0.005	2.473	1.315~4.650
同期颅脑手术	-1.811	0.744	5.929	0.015	0.163	0.038~0.702

组别	例数	出血体积[M(P₂₅，P₇₅)]	中位数差值(95%CI)
抗血小板组	11	0.75(0.20,1.77)	-0.800~0.280
未抗血小板组	17	0.50(0.22,0.74)	-0.800~0.280
Z值		0.541
P值		0.588

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