Risk Factors Of The Traumatic Intracerebral Hemorrhagic Progression After Decompressive Craniectomy In Patients With Traumatic Brain Injury

Objective: We aimed to investigate the risk factors associated with intracerebral hemorrhage following decompressive craniectomy for traumatic brain injury.Methods:We carried out a retrospective single center study of traumatic brain-injured patient patients who underwent decompressive craniectomy in the Neurosurgery Center of the first affiliated hospital of Xinjiang Medical University during a 5-year period time(January 2015 to October 2020).Results: A total of 117 cases met the inclusion criterion in this study,including 42 cases with intracerebral hemorrhagic progression and 75 cases of no intracerebral hemorrhagic progression.The result of regression analysis showed that magnitude of external cerebral herniation(OR=2.136,CI:1.168～3.895,P=0.011),lactic dehydrogenase(OR=1.005,CI: 1.001～1.010,P=0.015)were the risk factors for intracerebral hemorrhagic progression in patients with trauma brain injury following decompressive craniectomy,while time from injury to the first CT scan(OR=0.867,CI:0.768～0.942,P=0.006),duration of surgery(OR=0.439,CI: 0.220～0.808,P=0.012),a higher level of fibrinogen(OR=0.473,CI: 0.238～0.864,P=0.021)or platelet count(OR=0.989,CI: 0.980～0.998,P=0.017)were protective factors.Conclusion: In patients who were treated with decompressive craniectomy due to traumatic brain injury,a shorter time to the first CT scan after trauma,a higher level of lactic dehydrogenase or a severer magnitude of external herniation was potential risk factor for postoperative intracerebral hemorrhagic progression,while a longer duration of surgery,a higher level of fibrinogen or platelet count of patients was considered as a protective factor.