Establishment of an individualized risk nomogram model for predicting postoperative hydrocephalus in patients with severe craniocerebral injury

doi:10.19854/j.cnki.1008-2425.2024.03.0008

Abstract

Abstract: Objective To construct the nomogram model of postoperative hydrocephalus in patients with severe craniocerebral injury.Methods A total of 148 patients with severe craniocerebral injury who entered the hospital for surgical treatment from February 2019 to July 2022 were selected as the study objects.Logistic regression was used to screen the risk factors of postoperative hydrocephalus in patients with severe craniocerebral injury.R software was used to build the nomogram model of postoperative hydrocephalus in patients with severe craniocerebral injury,and the nomogram model was internally verified.Results Among 148 patients with severe craniocerebral injury,39 cases were complicated with hydrocephalus after operation,and the incidence of hydrocephalus was 26.35%(39/148).Logistic regression analysis showed that ventricular hemorrhage,subarachnoid hemorrhage,open injury,decompressive craniectomy and large bone window area(≥120 cm²) were the risk factors for postoperative hydrocephalus in patients with severe head injury.Based on the risk factors,a nomogram model was established for patients with severe craniocerebral injury complicated with hydrocephalus after surgery.The correction curve of the nomogram model for patients with severe craniocerebral injury complicated with hydrocephalus after surgery showed that the predicted probability was basically consistent with the actual probability,and the area under the ROC curve of the model was 0.876(95%CI:0.814~0.938).Conclusion Ventricular hemorrhage,subarachnoid hemorrhage,open injury,decompressive craniectomy and large bone window area are risk factors for postoperative hydrocephalus in patients with severe craniocerebral injury.The accuracy of the nomographic model of postoperative hydrocephalus in patients with severe craniocerebral injury is good.

Key words: Severe craniocerebral injury, Surgery, Hydrocephalus, Risk factors, Nomogram model

摘要： 目的构建重型颅脑损伤患者术后并发脑积水的列线图模型。方法选取2019年2月至2022年7月进入医院进行手术治疗的148例重型颅脑损伤患者作为研究对象。采用Logistic回归筛选重型颅脑损伤患者术后并发脑积水的危险因素,采用R软件构建重型颅脑损伤患者术后并发脑积水的列线图模型,并对列线图模型进行内部验证。结果 148例重型颅脑损伤患者中有39例患者术后并发脑积水,脑积水的发生率为26.35%(39/148)。Logistic回归分析结果显示,脑室出血、蛛网膜下腔出血、开放性损伤、去骨瓣减压术及骨窗面积较大(≥120 cm²)是重型颅脑损伤患者术后并发脑积水的危险因素。基于危险因素建立了重型颅脑损伤患者术后并发脑积水的列线图模型,重型颅脑损伤患者术后并发脑积水的列线图模型校正曲线显示预测概率和实际概率基本一致,模型的ROC曲线下面积是0.876(95%CI:0.814~0.938)。结论脑室出血、蛛网膜下腔出血、开放性损伤、去骨瓣减压术及骨窗面积较大是重型颅脑损伤患者术后并发脑积水的危险因素,构建的重型颅脑损伤患者术后并发脑积水的列线图模型的准确性较好。

关键词: 重型颅脑损伤, 手术, 脑积水, 危险因素, 列线图模型

CLC Number:

R651

Wei Shulan, Chen Weiyu, Hua Shengsong. Establishment of an individualized risk nomogram model for predicting postoperative hydrocephalus in patients with severe craniocerebral injury[J]. Chinese Journal of Stereotactic and Functional Neurosurgery, 2024, 37(3): 165-170.

魏曙岚, 陈炜钰, 花胜松. 个体化预测重型颅脑损伤患者术后并发脑积水的风险列线图模型的建立[J]. 立体定向和功能性神经外科杂志, 2024, 37(3): 165-170.

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