Risk factors for prognosis in patients with traumatic brain injury: A retrospective observational study

To explore independent risk factors for early prognosis prediction in patients with traumatic brain injury (TBI). Retrospective observational study. Trauma center of a tertiary care hospital in Shenzhen, Guangdong, China. A total of 321 patients with TBI from January 2020 to December 2022. To identify risk factors that could predict the prognosis of patients with TBI, and explore the relationship between coagulation function, progressive hemorrhagic injury (PHI), and prognosis. Baseline characteristics, coagulation function-related measurements at admission, and occurrence of PHI were retrospectively obtained from medical records. Patient prognosis was evaluated by Glasgow outcome scale (GOS) score 1 month after hospital admission. Bivariate and multivariate logistic regression analyses were performed to identify risk factors associated with patient prognosis. The receiver operating characteristic curve analysis was applied to evaluate the diagnostic potential of each risk factor. There were 162 patients with good prognosis (GOS 4-5) and 159 patients with poor prognosis (GOS 1-3). Bivariate and multivariate logistic regression analyses showed the development of PHI (odds ratio [OR] = 11.154, 95% confidence interval [CI]: 4.926-25.260), brain herniation (OR = 8.588, 95% CI: 3.510-21.014), coagulation disorders (OR = 7.961, 95% CI: 3.676-17.242); history of blood transfusion within 24 hours of admission (OR = 3.474, 95% CI: 1.517-7.953); multiple injuries (OR = 3.277, 95% CI: 1.453-7.392); fluid replacement volumes within 24 hours of admission (OR = 2.881, 95% CI: 1.367-6.072); and Glasgow coma scale scores (OR = 2.523, 95% CI: 1.414-4.501) to be independent risk factors for poor prognosis. PHI had the highest area under the curve in receiver operating characteristic analysis. The occurrence of PHI, brain herniation, coagulation disorders, history of blood transfusion within 24 hours of admission, multiple injuries, fluid replacement volumes ≥ 2000 mL within 24 hours of admission, and low Glasgow coma scale scores could predict poor short-term prognosis in TBI patients.