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JMBS 2019, 4(2): 159–167
https://doi.org/10.26693/jmbs04.02.159
Clinical Medicine

Possibilities of Logistic Analysis in the Construction of Prognostic Models of Personal Risk Assessment of Developing Complications as a Result of Subarachnoidal Hemorrhage

Polkovnikova K. Yu. 1, Polkovnikov A. Yu. 2
Abstract

Subarachnoid hemorrhage is one of the most common forms of intracranial vascular disease. According to various sources its frequency in population is from 5.2 to 19.4 cases per 100,000 population per year. This is 8.7-13.0% of the number of all disorders of the cerebral circulation. In 85% of cases, the cause of spontaneous subarachnoid hemorrhages is the rupture of saccular aneurysms in the basal part of the brain. The purpose of this work was to evaluate the prognostic significance and informativeness of some clinical indicators, highlighting the most optimal and reliable potential factors in the development of a mathematical equation for calculating the personal probability of complications in patients with subarachnoid hemorrhage of a traumatic etiology. Material and methods. We examined 87 patients with subarachnoid hemorrhages, among them 38 (43.68%) patients had isolated subarachnoid hemorrhage, 14 (16.09%) patients had subarhynodally parenchymal, 29 (33.33%) patients were with subarhynodally-ventricular, 6 (6.9%) patients were with subarachnoidal-parenchymal-ventricular hemorrhage. The total number of mixed hemorrhages was 56.32%. The distribution by age is typical for this disease. The majority of patients was from 30 to 60 years old, with predominance of patients aged 40-60, elderly patients (over 60 years old) encompassed 20.7%. The average age was 49.97 years. Our study included 44 men, and 43 women. Results and discussion. The obtained results showed a significant value of some repressor’s in the a priori risk assessment of the endpoint in secondary ischemia, hydrocephalus and / or cerebral vasospasm, which allowed considering them not only as predictors of unfavorable prognosis and potential factors of complications, but also as indicators for the correct determination of individual cumulative risk with subarachnoid hemorrhages. It is important to identify such pathogenetic factors as metabolic metabolism of copeptin, hyponatremia, signs of increasing vascular spasm (the severity of the condition was more than III inclusive on the Hunt-Hess scale) and old age. Conclusions. The developed algorithm and model of prognostic criteria for the quantitative assessment of the risk of complications and the effectiveness of the intensive care carried out would allow selecting the pathogenetically determined individual treatment strategy and implement a set of measures to prevent the development of vital and neurological disorders.

Keywords: atraumatic subarachnoid hemorrhage, C.S. Ogilvy, copeptin, SIADH syndrome, hyponatremia, prognosis, logistic regression

Full text: PDF (Ukr) 239K

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