Analysis of influencing factors of post-traumatic stress disorder associated with traumatic brain injury

WANG Songqing; YANG Hua; HUANG Renqiang; XIAO Xian; XIONG Wei; LIANG Haihui; CHEN Zhipeng; LU Kun; YUAN Qijun; CHANG Dachuan

Abstract：Objective To explore the influencing factors of post-traumatic stress disorder(PTSD)in patients with traumatic brain injury(TBI).Methods The clinical data of 90 patients with TB1 admitted from 2020 to 2022 were analyzed retrospectively.The clinical prognosis was evaluated according to the Glasgow Outcome Scale(GOS)score.Fifty-six patients with good prognosis were included in the evaluation of PTSD using the DSM-5 PTSD diagnosis and statistics manual,and the relevant indexes of blood and cerebrospinal fluid at admission were collected for statistical analysis.Results The prevalence of PTSD in TBI patients was 39.3％.Compared with patients without PTSD,the plasma white blood cell(WBC),neutrophil,neutrophil/lymphocyte ratio(NLR),C-reactive protein(CRP),cerebrospinal fluid WBC-BF and cerebrospinal fluid protein content in patients with PTSD had obvious statistical significance(P＜0.05,P＜0.01).Logistic regression analysis showed that neutrophils(OR=3.735,95％CI:1.109-12.577,P=0.033),NLR(OR=3.742,95％CI:1.12-12.591,P=0.033)and cerebrospinal fluid WBC-BF(OR=1.216,95％CI:1.072-1.378,P=0.002)were influencing factors of PTSD.Neutrophil AUC was 0.880(P＜0.01),sensitivity was 63.6％,specificity was 97.1％;AUC value of NLR was 0.799(P＜0.01),sensitivity was 81.8％,specificity was 85.3％;AUC value of WBC-BF was 0.889(P＜0.01),sensitivity was 81.8％,specificity was 76.5％.Conclusion Neutrophils,NLR and cerebrospinal fluid WBC-BF were independent influencing factors of PTSD in TBI patients,with good predictive value,high sensitivity and specificity.Their monitoring is conducive to early prediction and early intervention to reduce the incidence rate of PTSD.