Abstract:

Objective To establish a prognostic model for early prediction of intracranial progressive hemorrhagic injury after traumatic brain injury. Methods The clinical data of 396 patients with traumatic brain injury were collected for development of prognostic model. The relationship between admissionrelated risk factors and progressive hemorrhagic injury was systemically analysed, prognostic model was established, and the performance of the model was validated by goodness-of-fit test and calculation of C statistical value. Scoring was performed on risk factors according to Logistic β regression coefficient, and risk factor scoring system was established through linear function transformation. Prognostic model was ascertained after exterior validation. The prediction tool for intracranial progressive hemorrhagic injury after traumatic brain injury for clinical use was developed. Results Logistic regression analysis revealed that age≥57 years, decreased platelet count, prothrombin time＞14 s, D-dimer≥5 mg/L, blood glucose≥10 mmol/L, intraparenchymal hemorrhage/brain contusion and midline shift ≥5 mm were independent prognostic factors of intracranial progressive hemorrhagic injury after traumatic brain injury. The performance of prognostic model developed from admission related risk factors was good, with P>0.05 for goodness-of-fit test and 0.864 for C statistical value. Exterior validation demonstrated that the prognostic model had a powerful exterior applicability, with P>0.05 for goodness-of-fit test and 0.862 for C statistical value. Patients were divided into low risk group, intermediate risk group and high risk group with risk factor scoring system. The prevalences of progressive hemorrhagic injury were 10.3%, 47.3% and 85.2% respectively in the development cohort, and those were 10.9%, 47.3% and 86.9% respectively in the validation cohort. Conclusion The established prognostic model may conveniently and accurately predict the occurrence of intracranial progressive hemorrhagic injury after traumatic brain injury in the early stage, and the developed prediction tool may help in the dicision making in clinics.

Key words: prognostic model, prediction, traumatic brain injury, validation, progressive hemorrhagic injury