The Incidence And Relative Risk Factors Analysis Of Post-traumatic Hydrocephalus After Moderate And Severe Traumatic Brain Injury

Objective： Post-traumatic hydrocephalus is one of the majorcomplications of traumatic brain injury, seriously affect the quality oflife of patients, causing heavy economic burden to the whole society andpersonals. The aim of this paper is to explore the risk factors forpost-traumatic hydrocephalus, we try to find out the relationshipbetween PTH and admission informations of patients, in order to findsome methods to control and reduce the incidence of hydrocephalusafter traumatic brain injury.Methods： We search the database of medical records ofpatients,who suffers moderate or severe traumatic brain injury,hospitalized in our hospital during september.1st2007to october31st,2012. The clinical and imaging features were analyzed by regressionstatistical analysis, using single factor and multiple factor.Results：1.Univariate analysis showed that age, admission Glasgowcoma score(GCS),decompressive craniectomy,midline shift, subarachnoi-d hemorrhage have connection with traumatic subdural effusion;2.Multiple regression analysis indicated that decompressivecraniectomy, midline shift, subarachnoid hemorrhage is closely related to subdural effusion, while age, admission GCS is irrelevant;The partialregression coefficient of decompressive craniectomy is1.102, the valueof OR is3.010,95%confidence interval is between1.409and4.345;The partial regression coefficient of midline shift is1.072, the value ofOR is2.921,95%confidence interval is between1.199and4.241; Thepartial regression coefficient of subarachnoid hemorrhage is1.139, thevalue of OR is3.124,95%confidence interval is between1.506and4.857.3.Univariate analysis showed that admission Glasgow coma score(GCS), decompressive craniectomy, reaction of pupils, midline shift,subarachnoid hemorrhage, intraventricular hematoma and subduraleffusion have connection with post-traumatic hydrocephalus;4.Multiple regression analysis indicated that admission Glasgowcoma score, decompressive craniectomy, subarachnoid hemorrhage,intraventricular hematoma, subdural effusion is closely related topost-traumatic hydrocephalus. The partial regression coefficient ofadmission Glasgow coma score is1.399, the value of OR is4.051,95%confidence interval is between2.606and6.297; The partial regressioncoefficient of decompressive craniectomy is1.744, the value of OR is0.009,95%confidence interval is between3.484and9.387; The partialregression coefficient of subarachnoid hemorrhage is3.272, the value ofOR is26.364,95%confidence interval is between7.796and65.133; The partial regression coefficient of intraventricular hematoma is1.859,the value of OR is6.417,95%confidence interval is between3.982and10.568; The partial regression coefficient of subdural effusion is1.560,the value of OR is4.759,95%confidence interval is between3.169and7.611.Conclusions：1. Among385patients of moderate or severetraumatic brain injury, there are118cases of subdural effusion,42casesof hydrocephalus.2. Decompressive craniectomy, midline shift, subarachnoidhemorrhage were the independent risk factors of traumatic subduraleffusion;3. The admission Glasgow coma scores, decompressive craniotomy,intraventricular hemorrhage, subarachnoid hemorrhage, subduraleffusion were independent risk factors of post-traumatic hydrocephalus.In order to reduce the incidence of hydrocephalus and improve theprognosis of patients with moderate to severe traumatic brain injury,intermetion measures aim at risk factors mentioned above can be ofgreat importance.