Relationship Between CT Classification Of Cerebral Edema And Prognosis After Traumatic Brain Injury

Background And Objective Traumatic craniocerebral injury(TBI)is one of the most serious injury types.Traumatic cerebral edema is one of the most serious complications in patients with traumatic brain injury,which is mainly seen in the secondary cascade reaction after cerebral contusion(CC).The prognosis of patients is often poor,which brings great pressure to clinical neurosurgeons.Therefore,this study conducted CT grading of edema in the included patients.In addition,in order to comprehensively analyze the correlation between the classification and prognosis of patients with cerebral contusion,Further extracted baseline data,imaging characteristics and laboratory tests,and developed and validated a Nomograph prediction model to evaluate the clinical prognosis of patients.Methods A total of 426 patients were included in this study,We randomly divided the cohort into a training cohort(n=284)and a validation cohort(n=142)with a ratio of 2:1.At Least absolute shrinkage and selection operator(Lasso)regression wereused for screening high-risk factors afecting patient prognosis and development of the predictive model.The identifcation ability and clinical application value of the prediction model were analyzed through the analysis of receiver operating characteristic curve(ROC),calibration curve,and decision curve analysis(DCA).Results Twelve independent prognostic factors,including age,Glasgow Coma Score(GCS),Basal cistern status,Midline shift(MLS),Third ventricle status,intracranial pressure(ICP)and CT grade of cerebral edema,etc,were selected by Lasso regression analysis and included in the nomogram.The model showed good predictive performance,with a C index of(0.87,95% CI,0.026–0.952)in the training cohort and(0.93,95% CI,0.032-0.965)in the validation cohort.Clinical decision curve analysis(DCA)also showed that the model brought high clinical benefits to patients.Conclusion:CT grading of cerebral edema is an independent risk factor for poor prognosis.This study established a high accuracy of nomogram model to predict the prognosis of patients with Traumatic cerebral edema,its low cost,easy to promote,is especially applicable in the acute environment,However,this model still has some limitations and deficiencies,which require large sample and multi-center prospective studies to verify and improve our results.