Risk Factors for Postoperative Subdural Effusion in Patients with Severe Traumatic Brain Injury and the Construction of a Column Chart Prediction Model
10.11969/j.issn.1673-548X.2025.06.020
- VernacularTitle:重症颅脑损伤患者术后硬膜下积液的危险因素及预测模型构建
- Author:
Xifeng SUN
1
;
Li DOU
1
;
Yong TANG
1
Author Information
1. 212300 丹阳市人民医院神经外科
- Publication Type:Journal Article
- Keywords:
Severe traumatic brain injury;
Subdural effusion;
Risk factors;
Column chart
- From:
Journal of Medical Research
2025;54(6):109-113,148
- CountryChina
- Language:Chinese
-
Abstract:
Objective To analyze the risk factors for postoperative subdural effusion(SE)in patients with severe traumatic brain in-jury(sTBI)and create a column chart to predict the occurrence of postoperative SE in patients.Methods A retrospective analysis was conducted on the data of 223 patients with sTBI admitted to The People's Hospital of Danyang from March 2020 to December 2023.They were divided into SE group and non-SE group based on with or without postoperative SE.24 items of data collected from the SE group and non-SE group were compared,and multivariate Logistic regression were applied to analyze and screen for risk factors of postoperative SE occurrence.The determined predictive variables were introduced into R software to construct a column chart model,and the area under the receiver operator characteristic curve(ROC)curve(area under the curve,AUC)and correction curve were applied to test the predic-tive performance of the model.Results The incidence of postoperative SE in sTBI patients was 27.80％(62/223).There were statisti-cally obvious differences between the SE group and the non-SE group in terms of Glasgow coma scale(GCS)scores at admission,hema-toma volume,proportion of basilar cistern compression,proportion of subarachnoid hemorrhage(SAH),midline displacement distance,dehydrating agent application time ≥7days,and postoperative intracranial infection rate(P＜0.05).The risk factors for postoperative SE in patients with sTBI mainly included admission GCS score of 3-5 points,hematoma volume＞40ml,basal pool compression,SAH,midline displacement distance≥10mm,and application time of dehydrating agent ≥7days.Internal validation showed that the AUC was 0.840(95％CI:0.784-0.896),and the goodness of fit Hosmer-Lemeshow test showed x2=6.860,P=0.552,with better curve fit-ting.Conclusion A column chart based on GCS score at admission,hematoma volume,whether the basal pool,whether SAH,midline displacement distance and time of dehydrating agent application has a good predictive effect on postoperative SE occurrence in sTBI patients.
