Risk factors for postoperative secondary hydrocephalus in patients with severe craniocerebral injury and construction of nomogram risk model

LAI Yanling; CAI Dongmei; ZHUO Jingjing; LI Hao; LI Wenhui

doi:10.7619/jcmp.20242442

Journal of Clinical Medicine in Practice > 2025 > 29(1): 94-97, 117. > DOI: 10.7619/jcmp.20242442

LAI Yanling, CAI Dongmei, ZHUO Jingjing, LI Hao, LI Wenhui. Risk factors for postoperative secondary hydrocephalus in patients with severe craniocerebral injury and construction of nomogram risk model[J]. Journal of Clinical Medicine in Practice, 2025, 29(1): 94-97, 117. DOI: 10.7619/jcmp.20242442

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Risk factors for postoperative secondary hydrocephalus in patients with severe craniocerebral injury and construction of nomogram risk model

1.
Department of Neurosurgery, the 910th Hospital of Joint Logistic Support Force of the Chinese People's Liberation Army, Quanzhou, Fujian, 362000
2.
Department of Organ Transplantation, Xiang'an Hospital of Xiamen University, Xiamen, Fujian, 361102
3.
Health Management Center, Xiang'an Hospital of Xiamen University, Xiamen, Fujian, 361102

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Received Date: June 09, 2024
Revised Date: September 05, 2024

Graphical Abstract

Abstract

Abstract

Objective
To explore the risk factors for postoperative secondary hydrocephalus in patients with severe craniocerebral injury and construct a nomogram prediction model.
Methods
A total of 360 patients with severe craniocerebral injury were selected as the study subjects, and divided into hydrocephalus group (n=34) and non-hydrocephalus group (n=326) based on the occurrence of postoperative secondary hydrocephalus. Logistic regression analysis was used to screen for risk factors of postoperative secondary hydrocephalus. A nomogram model for predicting postoperative secondary hydrocephalus in patients with severe craniocerebral injury was constructed based on the identified risk factors, and its predictive performance was validated.
Results
Among the 360 patients, 34 developed secondary hydrocephalus after surgery, with an incidence rate of 9.44% (34/360). Logistic regression analysis revealed that intracranial infection, ventricular hemorrhage, midline shift ≥12 mm, preoperative Glasgow Coma Scale (GCS) score of 3 to 5, decompressive craniectomy and dura mater opening were independent risk factors for postoperative secondary hydrocephalus in patients with severe traumatic brain injury (P < 0.05). The concordance index of the nomogram model constructed based on these risk factors was 0.874, and the area under the curve was 0.831.
Conclusion
The nomogram model constructed in this study based on factors such as intracranial infection, ventricular hemorrhage, midline shift, preoperative GCS score, decompressive craniectomy and dura mater opening, effectively predicts risk of postoperative secondary hydrocephalus in patients with severe traumatic brain injury. This model has clinical significance for early prevention and treatment.
- severe craniocerebral injury,
- hydrocephalus,
- risk factors,
- nomogram,
- intracranial infection

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References (16)

References

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Risk factors for postoperative secondary hydrocephalus in patients with severe craniocerebral injury and construction of nomogram risk model