Multiple-factor prognosis analysis of anterior communicating artery aneurysm

Objective To investigate multiple factors affecting outcomes of the anterior communicating artery (ACoA) aneurysm so as to provide evidence basis for improving its surgical treatment. Methods The clinical data of 553 patients with ACoA aneurysms were retrospectively studied who were admitted to Department of Neurosurgery, Affiliated Hospital of Qingdao University from January 1997 to October 2015.Therapeutic effect was set as the dependent variable.Univariate analysis and multivariate logistic regression analysis were conducted to examine 10 factors that possibly affected the outcomes and included the patient's age, gender, times of subarachnoid hemorrhage (SAH), characteristics of SAH on Computed Tomography (CT) scans, Hunt-Hess grade, morphological characteristics of aneurysm, surgical timing and approach, presence/absence of intraoperative rupture and postoperative complications. Results The six factors including the patient's age , gender, morphological characteristics of aneurysm, timing and approach of surgery , intraoperative rupture did not play a role in affecting the surgical outcomes. The remaining 4 factors affected the patients' outcomes and were times of SAH, CT characteristics of SAH, Hunt-Hess grade and postoperative complications. Furthermore, the times of SAH(OR=3.404, P=0.000, 95%CI: 1.592-7.277), Hunt-Hess grade (OR=11.158, P=0.000, 95%CI: 3.355-37.103) and postoperative complications (OR=15.019, P=0.000, 95%CI: 3.017-61.793) were independent risk factors influencing the outcome. Conclusion Times of SAH, Hunt-Hess grade and postoperative complications are independent risk factors affecting the surgical outcomes of ACoA aneurysms. Key words: Intracranial aneurysm; Anterior communicating artery aneurysms; Microsurgery; Prognosis; Multiple factor analysis