老年重型颅脑损伤合并脑疝患者预后不良的危险因素分析OACSTPCD

Objective To investigate the risk factors of poor prognosis in elderly patients with severe traumatic brain injury(sTBI)complicated with cerebral hernia.Methods The clinical data of 231 elderly patients with sTBI complicated with cerebral hernia were retrospectively analyzed,which were admitted to Neurosurgery Department of Fujian Medical University Fuzong Clinical Medical College and Neurosurgery Department of Cangshan Campus of Fujian Medical University.According to GOS score,the patients were divided into good prognosis group and poor prognosis group.The relevant factors affecting prognosis were screened out,and the independent risk factors affecting prognosis were found by binary Logistic regression analysis.Results Among the 231 patients,106 had a good prognosis and 125 had a poor prognosis.There were statistically significant differences between the two groups of patients in terms of age,gender,admission GCS score,Chalson comorbidity index(CCI),abnormal pupil reflex,disappearance of cisterna ambiens,intraoperative encephalocele,midline shift,and blood oxygen saturation＜90％(P＜0.05).Binary Logistic regression analysis showed that age＞70 years old,CCI≥2 points,disappearance of the cisterna ambiens,blood oxygen saturation＜90％,and intraoperative encephalocele were independent risk factors for poor prognosis.Conclusion Age＞70 years old,CCI≥2 points,disappearance of the cisterna ambiens,blood oxygen saturation＜90％,and intraoperative encephalocele are independent risk factors for poor prognosis in elderly patients with sTBI complicated with cerebral hernia.Clinically,these risk factors of poor prognosis should be fully considered and effective measures should be taken to improve the prognosis in time.