Prognostic Risk Factors For Short-term Mortality After Surgical Intervention For Traumatic Brain Injury And Intracranial Hematoma

Objective: To reduce the mortality of traumatic brain injury patients with intracranial hematoma by studying the prognostic risk factors for short-term mortality after surgery.Methods: A retrospective analysis of 141 patients with intracranial hematoma admitted to the Neurotraumatic Surgery Department of the First Hospital of Jilin University from January 2013 to December 2015 was made.Patients were grouped according to preoperative preparation time,GCS score,midline deviation,diabetes mellitus,hypertension,hematoma volume,age,sex,surgical type,multiple trauma and pupil reactivity.Chi square test was used to compare the 14 day mortality of patients in different groups.Kaplan-Meier analysis and Cox proportional hazard regression model were used to analyze single and multiple prognostic factors.Statistical analysis was performed with SPSS 22 software,and P < 0.05 was statistically significant.Thirty-eight TBI patients with intracranial hematoma treated by surgery from January 2016 to August 2016 were used to verify the results.Results: About 17% of patients with traumatic brain injury and intracranial hematoma died within 14 days after operation.Kaplan-Meier analysis and logarithmic rank test showed that there were significant differences in mortality according to GCS score,preoperative preparation time,midline deviation,diabetes mellitus and pupil responsiveness.Univariate analysis showed that GCS score,midline offset,diabetes mellitus,and pupillary responsiveness were significantly associated with short-term survival,while longer preoperative preparation time was beneficial to short-term survival.Finally,age,GCS score and pupillary reactivity were independent risk factors for short-term survival.Conclusions: GCS score,preoperative preparation time,midline shift,diabetes mellitus and pupillary responsiveness had significant effects on short-term mortality after TBI.GCS score,age and pupillary responsiveness were the effective prognostic risk factors for short-term mortality.The older the age,the lower the GCS score and the poorer the pupillary responsiveness,the higher the short-term mortality of intracranial hematoma patients.