Shen Jun, An Qian, Hu Guanjie, Jiang Xiaochun, Zhang Shaolin
Department of Neurosurgery, The First Affiliated Hospital (YiJiShan Hospital) of Wannan Medical College, Wuhu City, Anhui 241001, PR China.
Department of Respiratory and Critical Care Medicine, Wuhu Hospital of Traditional Chinese Medicine, Wuhu City, Anhui 241001, PR China.
Injury. 2025 Sep;56(9):112446. doi: 10.1016/j.injury.2025.112446. Epub 2025 May 22.
Currently, there is a lack of literature reporting on the risk factors associated with various types of subdural effusion (SDE). The purpose of this study is to investigate the incidence, risk factors, and prognosis of different types of SDE that occur secondary to unilateral decompressive craniectomy (DC) in patients with traumatic brain injury (TBI).
A total of 417 patients who met the inclusion criteria were analyzed. The incidence, treatment, and prognosis of various types of SDE were examined. Risk factors associated with different types of SDE were identified through univariate analysis followed by multivariable logistic regression analysis.
The overall incidence of SDE was 50.6 %. There was no statistically significant difference in GOS scores among the various types of SDE (P = 0.511). Age (per 10-year increase) (OR, 1.471; 95 % CI, 1.201-1.802; P < 0.001), alcoholism (OR, 2.027; 95 % CI, 1.021-4.022; P = 0.043), combined with contralateral subdural hematoma (OR, 4.874; 95 % CI, 2.676-8.878; P < 0.001), and contralateral pneumocephalus after surgery (OR, 4.051; 95 % CI, 1.837-8.934; P = 0.001) were identified as independent risk factors for the occurrence of contralateral SDE. The type of injury (acute subdural hematoma, ASDH) (OR, 1.918; 95 % CI, 1.367-2.690; P <0.001), was an independent risk factor for the occurrence of ipsilateral SDE. Combined with contralateral subdural hematoma (OR, 2.669; 95 % CI, 1.161-6.139; P = 0.021) and contralateral pneumocephalus after surgery (OR, 2.271; 95 % CI, 1.177-4.381; P = 0.014) were independent risk factors for the occurrence of interhemispheric SDE.
Various types of SDE do not significantly affect the prognosis of patients with traumatic brain injury (TBI). Independent risk factors for the occurrence of contralateral SDE include age, alcoholism, and the presence of contralateral subdural hematoma and contralateral pneumocephalus following surgery. The type of injury being ASDH is the only risk factor for ipsilateral SDE. Combined with contralateral subdural hematoma and contralateral pneumocephalus after surgery were independent risk factors for the occurrence of interhemispheric SDE.
目前，缺乏关于各类硬膜下积液（SDE）相关危险因素的文献报道。本研究旨在调查创伤性脑损伤（TBI）患者单侧减压颅骨切除术（DC）后继发的不同类型SDE的发生率、危险因素及预后情况。
对417例符合纳入标准的患者进行分析。检查各类SDE的发生率、治疗情况及预后。通过单因素分析，随后进行多变量逻辑回归分析，确定与不同类型SDE相关的危险因素。
SDE的总体发生率为50.6%。各类SDE的格拉斯哥预后评分（GOS）之间无统计学显著差异（P = 0.511）。年龄（每增加10岁）（比值比[OR]，1.471；95%置信区间[CI]，1.201 - 1.802；P < 0.001）、酗酒（OR，2.027；95% CI，1.021 - 4.022；P = 0.043）、合并对侧硬膜下血肿（OR，4.874；95% CI，2.676 - 8.878；P < 0.001）以及术后对侧气颅（OR，4.051；95% CI，1.837 - 8.934；P = 0.001）被确定为对侧SDE发生的独立危险因素。损伤类型（急性硬膜下血肿，ASDH）（OR，1.918；95% CI，1.367 - 2.690；P < 0.001）是同侧SDE发生的独立危险因素。合并对侧硬膜下血肿（OR，2.669；95% CI，1.161 - 6.139；P = 0.021）和术后对侧气颅（OR，2.271；95% CI，1.177 - 4.381；P = 0.014）是大脑半球间SDE发生的独立危险因素。
各类SDE对创伤性脑损伤（TBI）患者的预后无显著影响。对侧SDE发生的独立危险因素包括年龄、酗酒以及术后存在对侧硬膜下血肿和对侧气颅。损伤类型为ASDH是同侧SDE的唯一危险因素。合并对侧硬膜下血肿和术后对侧气颅是大脑半球间SDE发生的独立危险因素。
