Analysis Of Risk Factors With The Development Of Hydrocephalus In Patients With Traumatic Brain Injury

Objective:Posttraumatic hydrocephalus(PTH)is a common complication in patients with traumatic brain injury(TBI),which is one of the important factors causing the deterioration of patients’ condition and poor prognosis.At present,National and international studies have focused on the occurrence and factor of PTH in patients who underwent decompressive craniectomy(DC),few studies on the risk factors of PTH in TBI as a whole.The aim of this study is to explore and analyze the occurrence and influencing factors of PTH in patients with TBI in order to identify its risk factors and provide a reference for the early identification of patients at risk for PTH.Materials and methods:The clinical data of patients with TBI admitted to the Department of Neurosurgery in the first affiliated hospital of Nanchang University from June 2016 to June 2021 were collected.Patients were divided into PTH and non-PTH groups according to whether hydrocephalus occurred within 6 months after the injury.The independent risk factors of PTH after TBI were determined by univariate analysis and multivariable binary logistic regression analysis,The receiver operating characteristic(ROC)curves were plotted and calculated area under the curve(AUC)values were used to assess the predictive power of each variable for PTH.Result:A total of 257 patients with TBI were eventually included in the study,of whom53(20.62%)developed PTH.The mean time of hydrocephalus was 39 ± 31.446 days after injury.In univariate analysis,PTH groups were compared to non-PTH groups,there were significant differences in age,glasgow coma scale(GCS)on admission,pupillary reactivity,midline shift,brain contusion,subdural hygroma(SDG),intraventricular hemorrhage(IVH),interhemispheric hygroma,duration of coma,intracranial infection and DC(P < 0.05).The results of stepwise multiple Logistic regression analysis showed that: Age(P = 0.042,OR = 1.025,95%CI 1.000-1.051),GCS on admission(P = 0.004,OR = 0.849,95%CI0.759-0.950),IVH(P = 0.001,OR = 3.270,95%CI 1.574-6.792),SDG(P = 0.026,OR = 2.500,95%CI 1.116-5.598),DC(unilateral P = 0.046,OR = 1.599,95%CI0.671-3.807;bilateral P = 0.016,OR = 5.627,95%CI 1.382-22.911)is an independent risk factor for PTH,And the risk of PTH is higher in patients with higher age and lower GCS scores.The area under the curve values calculated by plotting the ROC curve that the total model combining the factors(AUC=0.792)was a better predictor of the occurrence of PTH than any of the five risk factors.Conclusion:advanced age,low GCS on admission,SDG,IVH and DC were independent risk factors of posttraumatic hydrocephalus.Patients with the above risk factors should be alerted to the occurrence of PTH,closely observed,and given timely treatment.