Multivariate Analysis Of Prognosis In Patients With Epidural Hematoma Caused By Brain Injury

Background:Traumatic brain injury(TBI)has become a social problem that threatens public health in the world.Traffic accident injury is the leading cause of TBI.The epidural hematoma caused by TBI is mainly induced by brain trauma which leads to hematoma between the skull and endocranium.Surgical treatment is currently the most effective way to remove epidural hematoma.Due to the acute onset of epidural hematoma,it can easily lead to the formation of cerebral hernia,and postoperative complications are easy to occur,and ultimately increasing the risk of patients'poor prognosis.Therefore,it is particularly important to investigate the risk factors affecting the postoperative poor prognosis of patients with TBI-induced epidural hematoma.Objective:To explore the factors influencing the near-term prognosis of patients with epidural hematoma caused by brain trauma,so as to provide reference for the clinical treatment of this type of disease.Methods:The clinical data of 170 patients with epidural hematoma caused by TBI at Jiangsu University affiliated Yixing Hospital during the time from January2011 to December 2015 were collected and analyzed.The data mainly included age,gender,pupil changes,post-injury surgery time,and preoperative Glasgow coma scale(GCS)score,hematoma location,hematoma volume,other merged intracranial injuries,complications,and operation methods,etc.The patients were followed up during the hospitalization period and 6 months after the operation,and the prognosis of patients was graded strictly according to the Glasgow outcome scale(GOS),I for death,II for plant survival,III for severely disabled,IV for mild disabled and V for good recovery that can study and work normally.The study took I~III grades as poor prognosis.The analysis of single factors affecting the prognosis of patients was carried out by?~2 test and multiple factors were analyzed by Logistic multiple regression analysis.Test criteria:P<0.05 indicates statistical significance.Results:1 Analysis of single factors affecting the poor prognosis of patients with epidural hematoma caused by brain trauma:poor prognosis and favorable prognosis of patients with epidural hematoma caused by brain trauma had difference at age(?2=4.761,P=0.029),pupil changes(?2=10.827,P=0.001),post-injury surgery time(?2=5.271,P=0.022),preoperative GCS score(?2=6.452,P=0.011),hematoma volume(?2=3.953,P=0.047),and operation methods(?2=5.648,P=0.017),other merged intracranial injuries(?2=3.953,P=0.008)and complications(?2=4.675,P=0.031)and the difference had statistical significance(P<0.05 or P<0.01),but the difference in gender(?2=4.675,P=0.570),hematoma location(?2=1.776,P=0.212)had no statistical significance(P>0.05).2 Analysis of multiple factors affecting the poor prognosis of patients with epidural hematoma caused by brain trauma:age(P=0.023,OR=1.575,95%CI:1.125~2.062),pupil changes(P=0.008,OR=3.157,95%CI:2.251~5.035),post-injury surgery time(P=0.018,OR=2.231,95%CI:1.823~3.539),preoperative GCS score(P=0.012,OR=0.507,95%CI:0.321~0.833)),other merged intracranial injuries(P=0.036,OR=2.035,95%CI:1.579~3.152)were the independent influencing factors leading to poor prognosis of patients.Conclusion:1.Single factors affecting the poor prognosis of patients with epidural hematoma caused by brain trauma include:age,pupil changes,post-injury surgery time,preoperative GCS score,hematoma volume,operation methods,other merged intracranial injuries,complications.However,gender and hematoma location have no effect on the poor prognosis of patients.2.Age,pupil changes,post-injury surgery time,preoperative GCS score,and other merged intracranial injuries are the independent influencing factors leading to poor prognosis of patients,consistent with clinical experience.