Risk Factors Related To Cerebral Venous Sinus Thrombosis Secondary To Traumatic Brain Injury

Objective:Traumatic brain injury(TBI)was the first cause of death in young and middle-aged adults,which had high mortality and morbidity.Cerebral venous sinus thrombosis(CVST)was a serious complication in patients with TBI,which was not un-common but easily missed in diagnosis.The purpose of this study was to investigate the related risk factors of CVST associated with TBI and to build risk predictive model in order to decrease the misdiagnosis rate.Methods:The clinical date of 30 TBI patients with CVST was retrospectively analyzed as the CVST group,at our hospital from October 2014 to October 2019.And the clinical date of104 TBI patients without CVST was analyzed as the non-CVST group in recent five years.Sixteen possible related factors were included in this study.Univariate and multivariable logistic regression was performed to determine the independent predictors of CVST associated with TBI.The risk predictive model was established.The Hosmer-Lemeshow goodness-of-fit test was used to assess model calibration and the area under the receiver operating characteristic curve was used to assess model discrimination.Results:Seven factors(epidural hematoma extending sinus,skull fracture extending sinus,hyperdensity CT sign within venous sinus,Rotterdam CT scale grade,fracture of posterior fossa,brain hernia,age)were related to CVST in the univariate analysis results,with significant differences between the CVST and non-CVST group(P<0.05).These might be able related risk factors of CVST associated with TBI.Four factors(fracture extending sinus,epidural hematoma extending sinus,hyperdensity CT sign within venous sinus,Rotterdam CT scale 1-3)were identified as the independent risk predictors of CVST after head injury in multivariable analysis.(P<0.05)The risk forecast model was well calibrated(Hosmer-Lemeshow test,?~2=6.892,P=0.548).The model showed good discrimination for that the area under receiver operating characteristic curve was 0.921,95%confidence interval:0.865-0.977.Conclusion:Four factors(Rotterdam CT scale 1-3,fracture extending sinus,epidural hematoma extending sinus,hyperdensity CT sign within venous sinus)were the independent risk factors of CVST after head injury.Early identification of related risk factors would be beneficial to the diagnosis of CVST associated with TBI.The risk predictive model could predict the complication of CVST and had significant clinical value.