ROC Curve Analysis of Electrophysiological Monitoring and Early Warning During Intracranial Aneurysm Clipping.

Abstract

To explore the safe duration of temporary clipping of the parent artery under intraoperative electrophysiological monitoring. The clinical data of 97 patients who underwent intracranial aneurysm clipping under electrophysiological monitoring in the Department of Neurology, Affiliated Hospital of Qingdao University from June 2019 to June 2020 were retrospectively analyzed. The safety duration of temporary clipping was analyzed using receiver operating characteristic (ROC) curves, and the results were validated in clinical data. Temporary clipping during operation (P < 0.05) and electrophysiological warning during operation (P < 0.05) were related risk factors of a cerebral ischemia event after operation. The ROC curve was drawn for the duration of temporary clipping and the occurrence of intraoperative electrophysiological warning, and the area under the curve was 0.78 (P < 0.05). The optimal cutoff value was 372.5 seconds, the sensitivity was 0.818, and the specificity was 0.762. After reviewing the clinical data, P < 0.05 was statistically significant after a χ² test with 372.5 seconds equal to approximately 6 minutes. The ROC curve was drawn for the duration of temporary clipping and the time of postoperative ischemia, and the area under the curve was 0.667 (P < 0.05). The optimal cutoff value was 430.5 seconds, the sensitivity was 0.592, and the specificity was 0.842. Temporary intraoperative block is the risk factor for cerebral ischemia after operation. In this study, the temporary clipping time of the parent artery should not be longer than 6 minutes, and there is approximately 1 minute to adjust the current procedure after the electrophysiological warning to restore the baseline of intraoperative electrophysiological monitoring.