关键词: 蛛网膜下腔出血, 危险因素, 急性肾损伤, APACH Ⅱ评分

Abstract: Objective To analyze the risk factors for in-hospital death of patients for non-traumatic subarachnoid hemorrhage in the Neurosurgical Intensive Care Unit(NICU）.
Methods The clinical data of patients for non-traumatic subarachnoid hemorrhage (SAH) in the Neurological Intensive Care Unit (NICU) of Zhongnan Hospital of Wuhan University were analyzed retrospectively.Divided into operation group and non operation group,The clinical characteristics of patients in two groups were compared.Logistic regression model was used to analyze the risk factors of the mortality of patients,and then the receiver operating characteristic curve (ROC) was used to evaluate the predictive value of risk factors.
Results A total of 356 patients with non-traumatic SAH in NICU were included,including 303 patients in the surgical group and 53 patients in the non-surgical group.There were 58 deaths (19%) in the surgery group and 17 deaths (32%) in the non-surgery group.A total of 83 patients developed acute kidney injury,including 69 patients in the surgical group and 14 patients in the non-surgical group.Multi-logistic regression showed that AKI was the most powerful independent risk factors associated with the morality of surgical patients with non-traumatic  subarachnoid hemorrhage (SAH) in NICU(OR=5.095,95%CI 2.261～11.483,P＜0.001),other risk factors included hyperglycemia,high APACHE Ⅱscores.For predicting SAH mortality,APACHE Ⅱ scores displayed an excellent areas under the ROC curve (AUC=0.811,P＜0.001).
Conclusion AKI significantly increases the hospital mortality,which is an important factor affecting the prognosis of non-traumatic  subarachnoid hemorrhage (SAH)  surgical patients in NICU.The APACHE Ⅱ scores was the best predictor of mortality of patients.

Key words: subarachnoid hemorrhage, risk factors, acute kidney injury, APACHE Ⅱ scores