Risk factors and prediction model construction of poor prognosis in patients with traumatic craniocerebral injury treated with hyperbaric oxygen therapy

Objective: To explore the risk factors of poor prognosis in patients with traumatic craniocerebral injury treated with hyperbaric oxygen therapy and construct a prediction model, so as to provide a reference for further improving the prognosis of patients. Methods: A total of 182 patients with traumatic craniocerebral injury who received hyperbaric oxygen therapy in the Second Affiliated Hospital of Air Force Medical University from January 2021 to January 2023 were selected using the method of queue research. According to the Glasgow outcome scale(GOS) one month after treatment, they were divided into the poor prognosis group(n=119) and the good prognosis group(n=63). The clinical data of the two groups were compared. The logistic regression prediction model was constructed and the factors influencing the prognosis of hyperbaric oxygen therapy for traumatic craniocerebral injury were analyzed. The receiver operating characteristic(ROC) curve was used to analyze the value of multi-factor prediction of prognosis of hyperbaric oxygen therapy for traumatic craniocerebral injury. Results: The incidence of subarachnoid hemorrhage and disappearance of annular cisterna in the poor prognosis group was higher than that in the good prognosis group, and the platelet count and plasma fibrinogen level were lower than those in the good prognosis group(all P<0.05). The multivariate logistic regression model showed that subarachnoid hemorrhage and disappearance of annular cisterna were risk factors for the prognosis of patients with traumatic craniocerebral injury treated with hyperbaric oxygen therapy, and the increase of platelet count and plasma fibrinogen level were protective factors(all P<0.05). The areas under the ROC curve(AUC)of subarachnoid hemorrhage, disappearance of annular cisterna, platelet count and plasma fibrinogen for predicting the prognosis in patients with traumatic craniocerebral injury treated with hyperbaric oxygen therapy were0.649, 0.610, 0.794 and 0.779, respectively(all P<0.05), and the model was reliable and stable(AUC=0.894,P<0.05). Conclusion: Subarachnoid hemorrhage, disappearance of annular cisterna, decreased platelet count and decreased plasma fibrinogen level are the influencing factors of poor prognosis in patients with traumatic brain injury treated with hyperbaric oxygen therapy. The prediction model based on the above risk factors has a high predictive value for poor prognosis of patients.