Risk factors affecting prognosis in post-traumatic hydrocephalus patients after traumatic brain injury

Abstract

Objective To investigate the risk factors affecting the prognosis of patients with hydrocephalus after traumatic brain injury (TBI). Methods A retrospective case control study was performed to analyze the clinical data of 70 patients with hydrocephalus after TBI admitted to the Lianyungang Hospital of Xuzhou Medical University from March 2012 to October 2017, including 54 males and 16 females. The Glasgow Outcome Score (GOS) was used as an indicator to evaluate the prognosis of patients after 3 months of treatment. According to the GOS, the patients were divided into good prognosis group (GOS>3 points, 27 patients) and poor prognosis group (GOS≤3 points, 51 patients). A total of 18 factors including gender, age, Glasgow Coma Score (GCS) on admission, platelet count, coagulation function, plasma fibrinogen levels, D-Dimer concentration, brain contusion, subarachnoid hemorrhage, subdural hygroma, subdural hemorrhage, cerebral hernia, cisterna ambiens disappearance, decompressive craniectomy, cranioplasty, ventriculo-peritoneal (V-P) shunt implantation, intracranial infection, and duration of coma were first analyzed using univariate analysis. Multivariate logistic regression analysis was then performed on the statistically significant factors generated by univariate analysis. Results The univariate analysis indicated that the GCS at admission ≤8 points, cerebral hernia, subarachnoid hemorrhage, subdural hygroma, intracranial infection, cisterna ambiens disappearance, plasma fibrinogen increase, and duration of coma >2 months were associated with the prognosis of hydrocephalus after TBI (P 2 months, and plasma fibrinogen increase were significantly related to the adverse outcomes of hydrocephalus (P<0.05). The total consistence rate of the logistic regression equation for prognosis precliction was 89%. Conclusions The cisterna ambiens disappearance, duration of coma >2 months and plasma fibrinogen increase are the most important factors affecting the prognosis of hydrocephalus after TBI. Clinically, we should strictly control the indications of TBI and hydrocephalus after TBI, take active treatment measures, shorten the duration of coma, and timely monitor the changes in blood coagulation indexes such as plasma fibrinogen, thereby to improve the prognosis of patients with hydrocephalus after TBI. Key words: Hydrocephalus; Prognosis; Risk factor