Risk factors of mortality and severe disability in the patients with cerebrovascular diseases treated with perioperative mechanical ventilation

Table 1 Basic demographic information of the patients

Characteristic	Number
Age (mean ± SD)	55.46 ± 12.53
Preoperative GCS score, median (IQR)	9 (8, 15)
Male gender, n (%)	59 (53.15)
Smoking, n (%)
Yes	34 (30.63)
Hypertension, n (%)
Yes	80 (72.07)
Diabetes, n (%)
Yes	18 (16.22)
Diagnosis of neurovascular diseases, n (%)
Ischemic cerebrovascular disease	1 (0.90)
Hemorrhagic cerebrovascular disease	96 (86.48)
Brain tumor	4 (3.60)
Malformed or narrowed intracerebral blood vessels	10 (9.01)
SAH grading, n (%)
Non-SAH	62 (55.86)
I	12 (10.81)
II	13 (11.71)
III	18 (16.22)
IV	6 (5.41)
Surgical operation methods, n (%)
Aneurysm clipping	29 (26.13)
Aneurysm embolization	23 (20.72)
Craniotomy for hematoma removal	30 (27.03)
External ventricular drainage	12 (10.81)
Cranial drilling and drainage	8 (7.21)
Others	9 (8.11)
Mechanical ventilation time, median (IQR)	113 (69, 187)
Tracheotomy, n (%)
Yes	56 (50.45)
Time from admission to start using ventilator (h), median (IQR)	40 (4, 86)
Ventilation initiation, n (%)
Post-operation	94 (84.68)
Pre-operation	17 (15.32)
Operation hours (h), median (IQR)	3.3 (2.1, 4.7)
Reason for ventilation, n (%)
Pulmonary disease	55 (49.55)
Status epilepticus	9 (8.11)
Impaired respiratory center function	6 (5.41)
Shock	14 (12.61)
Brainstem compression	27 (24.32)

SAH: Subarachnoid hemorrhage; GCS: Glasgow coma scale; IQR: Interquartile range.

Table 2 Patients characteristics of the study population stratified by the functional outcome

Characteristic	Good recovery (n = 29)	Severe disability (n = 32)	Death (n = 50)	Statistical value	P value
Age, median (IQR)	55 (46, 63)	61 (50.5, 65)	59 (51.2, 66)	2.984	0.225
Male gender, n (%)	17 (58.6)	19 (59.4)	23 (46.0)	1.873	0.409
Smoking, n (%)
Yes	10 (34.5)	12 (37.5)	12 (24.0)	1.948	0.407
Hypertension, n (%)				4.524	0.104
Yes	19 (65.5)	20 (62.5)	41 (82.0)
Diabetes, n (%)				1.271	0.544
Yes	3 (10.4)	5 (15.6)	10 (20.0)
Tracheotomy, n (%)				4.298	0.115
Yes	12 (41.4)	21 (65.6)	23 (46.0)
Diagnosis of neurovascular diseases, n (%)				0.690	0.406
Ischemic cerebrovascular disease	1 (3.4)	0 (0.0)	0 (0.0)
Hemorrhagic cerebrovascular disease	22 (75.9)	29 (90.6)	45 (90.0)
Brain tumor	2 (6.9)	1 (3.1)	1 (2.0)
Malformed or narrowed intracerebral blood vessels	4 (13.8)	2 (6.2)	4 (8.0)
SAH, n (%)				5.609	0.234
Non-SAH	16 (55.2)	19 (59.4)	27 (54.0)
I	5 (17.2)	3 (9.4)	4 (8.0)
II	3 (10.3)	2 (6.3)	8 (16.0)
III	5 (17.2)	6 (18.8)	7 (14.0)
IV	0 (0)	2 (6.3)	4 (8.0)
Preoperative GCS score, median (IQR)	11 (9, 15)	9 (9, 10)	9 (8, 10)	12.575	0.002
Surgical operation methods, n (%)				15.956	0.082
Aneurysm clipping	8 (27.6)	13 (40.6)	8 (16.0)
Aneurysm embolization	9 (31.0)	2 (6.3)	12 (24.0)
Craniotomy for hematoma removal	5 (17.2)	9 (28.1)	16 (32.0)
External ventricular drainage	1 (3.4)	3 (9.4)	8 (16.0)
Cranial drilling and drainage	3 (10.3)	2 (6.2)	4 (8.0)
Others	3 (10.3)	3 (9.4)	2 (4.0)
Time from admission to start using ventilator (h), median (IQR)	50 (9, 80)	71.0 (26.2, 102.8)	27.0 (1.0, 74.5)	6.537	0.038
Operation hour (h), median (IQR)	3.5 (2.0, 5.3)	3.5 (2.8, 4.7)	3.1 (2.0, 4.4)	1.694	0.249
Ventilation initiation, n (%)				1.235	0.559
Postoperation	24 (82.8)	29 (90.6)	41 (82.0)
Preoperation	5 (17.2)	3 (9.4)	9 (18.0)
Mechanical ventilation time (h), median (IQR)	111.5 (64.5, 223.0)	127.0 (75.0, 182.5)	102.5 (69.5, 181.0)	0.98	0.613
Reason for ventilation, n (%)				11.033	< 0.001
Pulmonary disease	13 (44.8)	24 (75.0)	18 (36.0)
Status epilepticus	6 (20.7)	2 (6.3)	1 (2.0)
Impaired respiratory center function	3 (10.3)	1 (3.1)	2 (4.0)
Shock	7 (24.1)	1 (3.1)	6 (12.0)
Brainstem compression	0 (0.0)	4 (12.5)	23 (46.0)

SAH: Subarachnoid hemorrhage; GCS: Glasgow coma scale; IQR: Interquartile range.

Table 3 Analysis of risk factors for mortality and prognosis of patients after mechanical ventilation

Value	Estimate	Standard error	Wald	P value	OR	95%CI
[Outcome = 1]	-4.692	1.05	20.13	0.000	0.009	0.001	0.071
[Outcome = 2]	-3.128	1.00	9.80	0.002	0.044	0.006	0.311
Preoperative GCS score	-0.149	0.09	2.89	0.089	0.861	0.725	1.023
Time from admission to start using ventilator	0.000	0.00	0.03	0.865	1.000	0.995	1.006
Pulmonary disease	-2.345	0.63	13.95	< 0.001	0.096	0.028	0.328
Status epilepticus	-3.668	0.94	15.08	< 0.001	0.026	0.004	0.163
Impaired respiratory center function	-2.352	1.02	5.27	0.022	0.095	0.013	0.709
Shock	-2.359	0.79	8.94	0.003	0.095	0.020	0.444
Brainstem compression	-	-	-	-	-	-	-

GCS: Glasgow coma scale.