Development and Validation Evaluation of Clinical Prognosis Prediction Model for Emergency Decompressive Craniectomy in Severe Traumatic Brain Injury
Objective To construct a predictive model for the prognosis of emergency decompressive craniectomy in patients with severe craniocerebral injury and to evaluate and verify it.Methods The clinical data of patients with severe craniocerebral injury in 5 hospitals including Ganzhou People's Hospital from January 2015 to January 2021 were retrospectively analyzed.The outcome of patients at 6 months after operation was observed,and the GOS score 1-2 was divided into poor prognosis.Univariate and multivariate Logistic regression analysis was performed on the modeling data set to identify the independent predictors of poor prognosis at 6 months after decompressive craniectomy.The early prediction model of poor prognosis within 6 months after operation was constructed by R language programming,and the model was evaluated and verified.Results A total of 386 patients were included in the study and randomly divided into the modeling group(286 patients)and the validation group(100 patients).The overall poor prognosis rate of the modeling data set within 6 months was 55.59％.Age,GCS,blood loss＞750 ml,disappearance of ambient cistern,intraoperative hypotension,and APTT＞36 s were independent influencing factors for poor prognosis at 6 months after emergency decompressive craniectomy in patients with severe craniocerebral injury(P＜0.05).The prediction model was constructed by using the predictive factors.After evaluation and verification,it was suggested that the model had good discrimination ability and calibration.Conclusion The predictive model based on the predictive factors of overall poor prognosis at 6 months after decompressive craniectomy for craniocerebral injury is displayed in the form of predictive nomogram,and the verification results are excellent and can be applied to clinical practice.The prediction model is helpful to guide the doctor's clinical decision-making and can also be used as a reference for individualized treatment plan.
Traumatic brain injuryDecompressive craniectomyRisk factorsPrediction model
万方数据
维普
