Risk Factors For Subdural Effusion After Traumatic Brain Injury

Objective: There are many complications after traumatic brain injury,among which traumatic subdural effusion(TSE)is a common one.By analyzing the risk factors of subdural effusion after traumatic brain injury,this paper aims to deepen the understanding of the occurrence and development of subdural effusion and achieve early detection,prevention and treatment.Improve prognosis and quality of life.Methods: part 1: Experiment 1: retrospective analysis of all non-surgical patients with Traumatic brain injury from January 2016 to January 2018 in southwest medical university;According to whether subdural effusion after Traumatic brain injury were divided into two groups,respectively,to collect their age,sex,GCS score,if there is a traumatic subarachnoid hemorrhage,subdural hematoma,epidural hematoma,frontal and temporal lobe hematoma contusion,compression of basal cistern,and carries on the univariate analysis of the above factors,the meaningful multiariable logistic regression analysis.Part 2: a retrospective analysis of southwest university of medical sciences in January 2016-January 2018 all in patients with Traumatic brain injury surgery patients,according to whether after traumatic brain injury subdural effusion into two groups,respectively,to collect their age,sex,admission GCS score,if there is a traumatic subarachnoid hemorrhage,subdural hematoma,epidural hematoma,frontal and temporal lobe hematoma contusion,compression of basal cistern,whether to decompressive craniectomy and whether the midline shift of 5 mm,and carries on the univariate analysis of the above factors,the meaningful multiariable logistic regression analysis.Results: a total of 174(58%)of the non-surgical cases were male(139 cases)and female(35 cases),58 cases had subdural effusion,116 cases had no subdural effusion,and the incidence of subdural effusion was about 33%.Univariate analysis showed gender(P=0.238),age(P=0.000),GCS score(P=0.010),subarachnoid hemorrhage(P=0.550),epidural hematoma(P=0.271),subdural hematoma(P=0.502),frontal lobe hemorrhage and contusion(P=0.051),temporal lobe hematoma and contusion(P=0.068),basal cistern compression(P=0.010);univariate analysis showed that age(P=0.000),GCS score(P=0.010)were risk factors for TSE;multivariate logistic regression analysis showed that only age(OR,1.080,95% CI 1.050-1.111,P=0.000)was a risk factor for TSE.127 cases(42%)underwent operation,101 males and 26 females;46 cases had subdural effusion,81 cases had no subdural effusion,and the incidence of TSE was 36%.Among them,36 cases had decompressive craniectomy,20 cases had TSE and 16 cases had no TSE.Univariate analysis showed gender(P=0.118),age(P=0.446),GCS score(P=0.298),and subarachnoid hemorrhage(P=0.298).402),epidural hematoma(P=0.650),subdural hematoma(P=0.040),frontal lobe hematoma and contusion(P=0.369),temporal lobe hematoma and contusion(P=0.439),midline displacement greater than 5 mm(P=0.808),basal cistern compression(P=0.318),decompressive craniectomy(P=0.004),univariate analysis indicated that subdural hematoma(P=0.040),decompressive craniectomy(P=0.004)were risk factors for subdural effusion after traumatic brain injury.Multivariate logistic regression analysis showed that only decompressive craniectomy(OR,3.125,95% CI 1.405-6.951 P = 0.005)was a risk factor for subdural effusion after TBI.Univariate analysis showed that basal cistern compression(P=0.010)had statistical significance in non-operative group,but because the sample size of basal cistern compression was small in non-operative group,the logistic regression analysis of basal cistern compression in 301 cases in this study showed that basal cistern compression(OR,3.640,95% CI 1.870-7.084 P?0.01)was a risk factor.Conclusion: Traumatic subdural effusion is related to age,basal cistern compression and decompressive craniectomy.However,the risk factors of surgical and non-surgical conditions are different,and the occurrence of TSE should be prevented according to the different clinical characteristics of patients in clinical work.