Clinic investigation and logistic analysis of risk factors of recurrent hemorrhage after operation in the earlier period of cerebral hemorrhage.
Objective of this study was to investigate the incidence, time, location, prevention, treatment and risk factors of recurrent hemorrhage in the earlier period of cerebral hemorrhage after operation. Three hundred and twenty two patients with operations in the earlier period of cerebral hemorrhage were analyzed retrospectively. The clinical data of hemorrhage and recurrent cerebral hemorrhage groups were compared and statistically analyzed. Logistic regression analysis was applied to evaluate the function of possible factors leading to recurrent hemorrhage after operation. The incidence of recurrent hemorrhage was 21.4% in the earlier period of cerebral hemorrhage after operation. When the operation was performed after cerebral hemorrhage within 6 h, 6-12 h and 12-24 h, the incidence of recurrent hemorrhage after operation were 43.1%, 20.9%, 3.6% respectively. With regard to time of recurrent hemorrhage, the incidence was 3.1% within 12 h after operation, 15.5% between 12-24 h and just 2.8% after 24 h. Site of hemorrhage was in the basal ganglion in 92.6% of the cases. Mono-agent logistic analysis displayed that there is a significant correlation between high diastolic blood pressure, fluctuation of blood pressure after operation, taking anti-coagulant drugs for a long time, site of hemorrhage, difficult or not thorough hemostasis during operation and recurrent hemorrhage (p < 0.01). Multiple linear logistic regression analysis has shown that a remarkable diastolic blood pressure and fluctuation of blood pressure after operation are risk factors for recurrent hemorrhage. Their OR value were 10.32, 7.234. From this it is concluded that the incidence of recurrent cerebral hemorrhage after operation in the earlier period is 21.4%, which must never be ignored. The time period of 24 h after operation is a stage of high risk. Maintaining diastolic blood pressure below 85 mmHg and steadily controlling the pressure after operation are of great importance for prevention of recurrent cerebral hemorrhage.
Chen
S C
SC
Department of Neurosurgery, First Affiliated Hospital of Jinan University, Guangzhou, P. R. China. drcsc@263.net
Feng
G
G
D000328:Adult; D000368:Aged; D002681:China; D003399:Craniotomy / Q000706:statistics & numerical data*; D019299:Decompression, Surgical / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D020299:Intracranial Hemorrhage, Hypertensive / Q000453:epidemiology* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011379:Prognosis; D012008:Recurrence; D012189:Retrospective Studies; D018570:Risk Assessment / Q000379:methods*; D012307:Risk Factors; D016896:Treatment Outcome