Abstract:ObjectiveTo analyze the risk factors of clinical prognosison in patients with severe aneurysmal subarachnoid hemorhage (SaSAH) treated by surgical clipping. Methods From January 2010 to January 2020, 67 cases of SaSAH patients diagnosed by digital subtraction angiography (DSA) or CT angiography (CTA) and subarachnoid hemorrhage diagnosed by head CT. Intracranial aneurysm was treated by surgical clipping followed by nutritional support, neurocritical care and management. Follow up was performed 1 year after discharge by recording glasgow outcome scale (GOS), and the patients were divided into good prognosis group (39 cases) and poor prognosis group (28 cases). The clinical data of two groups were recorded, including gender, age, location of responsible aneurysm, Hunt-Hess grade, history of hypertension, history of diabetes and history of smoking. Univariate analysis and multivariate analysis were performed on the influencing factors of clinical prognosis of SaSAH patients. Results Univariate analysis showed that age and Hunt-Hess Scale were the risk factors of clinical prognosis in patients with SaSAH (P<0.05). Gender, hypertension, diabetes, smoking history and location of responsible aneurysms were not the factors influencing the prognosis of SaSAH patients (P>0.05). Multivariate analysis showed that age and Hunt-Hess Scale were the risk factors of clinical prognosis in patients with SaSAH (P<0.05). The risk of poor clinical prognosis in SaSAH patients aged ≥60 years was 5.430 times higher than that in SaSAH patients aged <60 years. The risk of poor clinical prognosis in patients with SaSAH increased by 3.231 times for each additional unit of Hunt-Hess Scale. Conclusion Compared with low age and low Hunt-Hess grade SaSAH patients, venerable age and high Hunt-Hess grade indicate poor prognosis. When SaSAH patients with high Hunt-Hess grade or venerable age are encountered in clinic, a comprehensive evaluation needs to be carried out before operation, and an individualized and targeted treatment plan should be formulated to reduce the incidence of adverse clinical prognosis as much as possible.