Influencing factors of cognitive dysfunction in patients with mild to moderate traumatic brain injury and establishment of nomogram prediction model
10.3969/j.issn.1004-1648.2023.06.009
- VernacularTitle:轻中度创伤性脑损伤患者遗留认知功能障碍的影响因素及列线图预测模型的构建
- Author:
Yi SUN
1
;
Wei YAN
;
Xingdong LIU
Author Information
1. 210029 南京医科大学第一附属医院神经外科
- Keywords:
mild to moderate traumatic brain injury;
cognitive dysfunction;
influencing factor;
nomogram
- From:
Journal of Clinical Neurology
2023;36(6):425-429
- CountryChina
- Language:Chinese
-
Abstract:
Objective To explore the influencing factors of cognitive dysfunction in patients with mild to moderate traumatic brain injury(TBI)and to establish a prognostic nomogram model.Methods A retrospective study was performed on 301 patients with mild to moderate TBI.Patients were divided into two groups according to whether the patients had cognitive dysfunction evaluated by the Montreal Cognitive Assessment Scale(MoCA).Independent influencing factors affecting long-term cognitive deficits in mild to moderate TBI patients were analyzed by Logistic regression analysis.A nomogram model for predicting the risk of cognitive deficits was established by using R software,and the predictive performance and compliance of the model were evaluated by using the consistency index(C-index)and the calibration curve.Results Among 301 patients with mild to moderate TBI,122 patients had long-term cognitive dysfunction,with an incidence rate of 40.5%.Multivariate analysis showed advanced age,lower GCS score,hyperlipidemia,contusion of the temporal lobe,subarachnoid hemorrhage,ICU admission were independent risk factors for cognitive dysfunction in mild to moderate TBI patients(all P＜0.05).More than 12 years of education and very early rehabilitation were independent protective factors for cognitive dysfunction in mild to moderate TBI patients(all P＜0.05).The nomogram model established based on the above 8 influencing factors had good predictive performance,and the nomogram model had a high predictive accuracy with a C-index of 0.845.Conclusions The probability of cognitive dysfunction in patients with mild to moderate TBI should be predicted through the nomogram model according to age,GCS score,hyperlipidemia,contusion of the temporal lobe,subarachnoid hemorrhage,ICU admission,education level and very early rehabilitation.The nomogram model could be used to guide assessment and intervention for improving prognosis of the patients.
