Objective To investigate the value of cranial CT cisternal grading combined with D-dimer(D-D)and Glasgow Coma Scale(GCS)score in predicting the short-term postoperative prog-nosis of patients with severe traumatic brain injury.Methods A total of 165 patients with severe trau-matic brain injury who were treated in the hospital from January 2019 to May 2024 were selected as study subjects,all underwent craniotomy surgery.Postoperative follow-up was conducted for 3 months to analyze the differences in clinical data and preoperative indicators such as cranial CT cisternal grad-ing,D-D levels,and GCS scores between patients with poor and good prognosis.The value of cranial CT cisternal grading,D-D levels,and GCS scores in predicting short-term postoperative poor prognosis in patients with severe traumatic brain injury was also analyzed.Results Compared with patients with good prognosis,patients with poor prognosis had higher proportion of age,cranial CT cisternal grading of Ⅰ to Ⅱ,D-D levels,and GCS scores＜6(P＜0.05).There were no statistically significant differences in C-reactive protein,prothrombin time,activated partial thromboplastin time,international normalized ratio,total cholesterol,triglycerides,high-density lipoprotein cholesterol,and low-density lipoprotein cholesterol levels between patients with poor and good prognosis(P＞0.05).Cranial CT cisternal grading,D-D levels,and GCS scores were influencing factors for short-term postoperative poor prognosis in patients with severe traumatic brain injury(P＜0.05).The area under the curve for poor prognosis by three indicators in combination was 0.941(95％CI,0.906 to 0.975),which was higher than the area under the curve for the individual predictions of cranial CT cisternal grad-ing,D-D levels,and GCS scores(P＜0.05).Conclusion The influencing factors for short-term postoperative prognosis in patients with severe traumatic brain injury include cranial CT cisternal grading,D-D levels,and GCS scores.The model based on these three indicators has certain appli-cation value in predicting patient prognosis.

Objective:To explore the risk factors for shunt dependent hydrocephalus (SDHC) in patients with traumatic subarachnoid hemorrhage (tSAH) and establish their risk nomogram model.Methods:Two hundred and sixty-nine patients with tSAH, admitted to our hospital from February 2018 to February 2022, were chosen in our study. All patients were followed up for 3 months after discharge; 51 patients were complicated with SDHC and 218 patients were not complicated with SDHC. The clinical data of patients with and without SDHC were compared. Multivariate Logistic regression analysis was used to determine the independent influencing factors for SDHC in tSAH patients; according to the results of multivariate Logistic regression analysis, a nomogram model was constructed to predict SDHC in tSAH patients; and the consistency index (C-index) and calibration curve were used to evaluate the predictive performance and compliance of the nomogram model.Results:As compared with patients without SDHC group, patients with SDHC had significantly lower Glasgow Coma Scale (GCS) scores on admission, and significantly higher proportions of patients with cerebral hernia, diffuse tSAH, tSAH thickness ≥5 mm, intraventricular hemorrhage, midline shift>12 mm, and epidural effusion at discharge, and patients accepted decompressive craniectomy ( P<0.05). Multivariate Logistic regression analysis showed that GCS scores of 13-15 ( OR=0.134, 95%CI: 0.024-0.740, P=0.021), diffuse tSAH ( OR=4.391, 95%CI: 1.680-11.475, P=0.003), tSAH thickness≥5 mm ( OR=4.114, 95%CI: 1.689-10.018, P=0.002), decompressive craniectomy ( OR=3.283, 95%CI: 1.278-8.433, P=0.014) and epidural hydrops ( OR=3.302, 95%CI: 1.137-9.593, P=0.028) were independent influencing factors for SDHC in tSAH patients. A nomogram model established based on the above 5 influencing factors showed high predictive accuracy with C-index of 0.877. Conclusion:The tSAH patients with low GCS scores at admission, diffuse tSAH, tSAH thickness≥5 mm, and epidural effusion, and patients accepted decompressive craniectomy are prone to have SDHC; the nomogram model based on the above variables has a high efficiency in predicting the risk of tSAH complicated with SDHC.