Risk factors of blunt cerebrovascular injuries in patients with traumatic brain injury

Wu Ya-qiu; Huang Guang-fu

doi:10.3969/j.issn.1002-1949.2018.01.016

Abstract：Objective To evaluate the disease characteristics of severe TBI patients complicated with blunt cerebrovascular injuries ( BCVI ) , the risk factors for BCVI and the effect of early anticoagulant therapy .Methods The patients with severe traumatic brain injury ( TBI ) treated in our department of neurosurgery were enrolled .The patients were divided into BCVI group and non -BCVI group according to the occurrence of BCVI .Univariate analysis was used to analyze the differences of clinical variables , BVCI grade , postoperative 6 months and 1 year prognosis between the two groups . Multivariate Logistic regression model was used to assess the risk factors of BCVI .The course of treatment and complications of BCVI patients were analyzed .Results 505 patients with severe TBI were enrolled , including 52 ( 10 .3％) BCVI patients and 453 non -BCVI patients .Multivariate Logistic regression analysis showed that risk factors of BCVI in patients with severe TBI:ISS score(O R=2.030, 95％CI1 .146～3.598 , P=0 .021), motorcycle collision (OR=2.448, 95％ CI 1.336～34.387, P=0.004), carotid artery involved fractures (OR=11.633, 95％ CI 1.250～83.965, P=0.009), cervical injury (OR=13.591, 95％ CI3 .498 ～54.879, P=0 .001), pulmonary contusion (O R=7.941, 95％CI 1.090～534.32 , P=0 .031), liver injury (O R=13.657, 95％ CI 2.765～80.379, P=0.007).Conclusion BCVI were common in patients with severe TBI .The main risk factors for BCVI in patients with severe traumatic brain injury are upper body injury ( involving carotid artery fracture, cervical injury, pulmonary contusion and liver injury ) and motorcycle crash injury. Early anticoagulant therapy for patients is safe and effective .