Wang Yong, Di Cuili, Zhao Guiliang, Zhao Yaqun
Department of Neurosurgery, The First Medical Center of Chinese PLA General Hospital Beijing, China.
Department of Neurosurgery, The Eighth Medical Center of Chinese PLA General Hospital Beijing, China.
Am J Transl Res. 2024 Dec 15;16(12):7716-7724. doi: 10.62347/JEDY7237. eCollection 2024.
To identify risk factors associated with progressive hemorrhagic injury (PHI) in patients with isolated traumatic brain injury (TBI) and to develop prognostic models for predicting patient outcomes.
A total of 137 patients with isolated TBI who underwent additional CT scans were included in the retrospective study. Single-factor analysis and multivariate logistic regression analysis were performed to identify significant risk factors associated with PHI development. Receiver operating characteristic (ROC) curve analysis was conducted to evaluate the diagnostic value of specific markers for predicting PHI.
Single-factor analysis revealed significant differences between the PHI group (62 patients) and the non-PHI group (75 patients) in various factors, including gender, etiology, pupillary size and reflex, midline shift, associated brain contusion, D-dimer (D-D) levels, neutrophil-to-lymphocyte ratio (NLR), platelet count, blood glucose levels, and Glasgow Coma Scale (GCS) score. Multivariate logistic regression analysis identified NLR, blood glucose level, and GCS score as significant risk factors for PHI in isolated TBI patients, and also identified GCS score, NLR, platelet-to-lymphocyte ratio (PLR), and age as significant factors for predicting prognosis. ROC curve analysis showed that NLR had significant auxiliary diagnostic value for predicting PHI.
NLR, blood glucose level, and GCS score are significant risk factors for PHI development in isolated TBI patients. The constructed prognostic model incorporating age, GCS score, NLR, and PLR offers valuable predictive capabilities for PHI patient outcome in isolated TBI cases.
确定单纯性创伤性脑损伤(TBI)患者发生进行性出血性损伤(PHI)的相关危险因素,并建立预测患者预后的模型。
本回顾性研究纳入了137例接受额外CT扫描的单纯性TBI患者。进行单因素分析和多因素逻辑回归分析,以确定与PHI发生相关的显著危险因素。进行受试者工作特征(ROC)曲线分析,以评估特定标志物对预测PHI的诊断价值。
单因素分析显示,PHI组(62例患者)和非PHI组(75例患者)在性别、病因、瞳孔大小和反射、中线移位、相关脑挫伤、D-二聚体(D-D)水平、中性粒细胞与淋巴细胞比值(NLR)、血小板计数、血糖水平和格拉斯哥昏迷量表(GCS)评分等多种因素上存在显著差异。多因素逻辑回归分析确定NLR、血糖水平和GCS评分是单纯性TBI患者发生PHI的显著危险因素,还确定GCS评分、NLR、血小板与淋巴细胞比值(PLR)和年龄是预测预后的显著因素。ROC曲线分析表明,NLR对预测PHI具有显著的辅助诊断价值。
NLR、血糖水平和GCS评分是单纯性TBI患者发生PHI的显著危险因素。构建的包含年龄、GCS评分、NLR和PLR的预后模型为单纯性TBI病例中PHI患者的预后提供了有价值的预测能力。