Establishment And Evaluation Of Early Prediction Model For Prognosis Of Patients With Moderate And Severe Traumatic Brain Injury

Objective:To explore the related factors that influence the in-hospital mortality and long-term prognosis of patients with moderate and severe traumatic brain injury,and to evaluate the value of GCS score and CT score in predicting the prognosis of moderate and severe craniocerebral injury.Methods:The clinical data of 248 patients with moderate or severe traumatic brain injury admitted to the Department of Neurosurgery in Shanxi Provincial People’s Hospital from June 2019 to 2021 were collected.The results including age,GCS-P score,Helsinki CT score,Marshall CT score,Rotterdam CT score,blood routine,coagulation examination,and survival in hospital.Using SPSS 26.0 software to carry on the single factor,the multi-factor analysis,and screening prognosis related independent risk factors.Logistic regression was used to analyze the risk factors of in-hospital mortality and long-term prognosis of patients with moderate and severe traumatic brain injury.Results:Among 248 patients with moderate or severe traumatic brain injury,the mortality rate in hospital was 12.9%(32/248),the rate of death or vegetative state was 19.4%(40/248),the rate of severe disability was 19.4%(40/248),and the rate of moderate disability was 29.0%(72/248),mild disability or good rate was 32.2%(80/248).Multivariate analysis showed that GCS motor score and Rotterdam CT score(p < 0.05)were the independent risk factors for in-hospital mortality of patients with moderate or severe traumatic brain injury,and age,GCS-P score and Helsinki CT score(p < 0.05)were independent risk factors for predicting the long-term prognosis of patients with moderate or severe traumatic brain injury.Its efficacy in predicting in-hospital mortality and long-term prognosis was significantly higher than that of single index.Conclusion:(1)GCS motor score and Rotterdam CT score were independent risk factors for in-hospital mortality of patients with moderate or severe traumatic brain injury.Age,GCS-P score and Helsinki CT score were independent risk factors for long-term prognosis in patients with moderate or severe traumatic brain injury.(2)The model of GCS motor score+Rotterdam CT score was the strongest predictor of in-hospital mortality,and the model of age+GCS-P score+Helsinki CT score was the strongest predictor of long-term prognosis.