Analysis of risk factors for early cognitive impairment after endovascular treatment for mild aneurysmal subarachnoid hemorrhage

Abstract:

Objective To explore the risk factors for early impairment in patients with mild aneurysmal subarachnoid hemorrhage（ASAH） after endovascular treatment.Methods From a retrospectively collected institutional database，we investigated 80 mild ASAH patients who had endovascular treatment between December 2015 and December 2021. All patients were followed up with the mini-mental state examination（MMSE） and modified Rankin scale（mRS） at one month and three months after endovascular treatment respectively. The patients were classified into normal group and cognitive impairment group according to cognitive status. The clinical baseline data of the two groups of patients were collected and the risk factors of cognitive impairment were analyzed by univariate and multivariate analysis.Results Among the 80 patients，41 had cognitive impairment one month after treatment，accounting for 51.25% of the total number. The univariate analysis of the risk factors for cognitive impairment showed that education level（P=0.000），age（P=0.020），modified Fisher scale（mFS） at admission（P<0.001），Hunt-Hess grade（P<0.006），location of aneurysm（P=0.023），intraventricular hemorrhage（P=0.043） were risk factors for cognitive impairment； the multivariate analysis showed that the mFS，the location of aneurysm，Hunt-Hess scale and intraventricular hemorrhage were independent risk factors for postoperative cognitive impairment（P<0.05），and the cognitive function of all patients returned to normal 3 months after surgery.Conclusion This study found that the incidence of cognitive impairment at 1 month after endovascular treatment for mild ASAH patients was 51.25%. Education level，age，mFS at admission，Hunt-Hess grade，the location of aneurysm，intraventricular hemorrhage are risk factors for cognitive impairment after the surgery. mFS，aneurysm location，Hunt-Hess grade，and intraventricular hemorrhage are independent risk factors for cognitive impairment.