Risk factors affecting venous thromboembolism in patients with critical brain injury during hospitalization and the construction of a risk prediction model

CAI Lin; PAN Chuanliang; ZHANG Chuan; WANG Zhong; MA Yi; TAN Yanrui; YU Hong

Abstract：Objective To explore the risk factors of venous thromboembolism(VTE)in patients with critical brain injury during hospitalization and to establish a risk prediction model.Methods 202 patients with critical craniocerebral injury from September 2021 to August 2024 were selected as the subjects of this study.According to VTE occurrence during hospitalization,they were divided into VTE group(n=44)and non-VTE group(n=158).Factors affecting the occurrence of VTE in patients with critical craniocerebral injury during hospitalization were investigated by Binary Logistic stepwise regression,and a nomogram model was constructed.The value of the nomogram model in predicting VTE during hospitalization in patients with critical brain injury was evaluated by ROC.Results The proportion of patients in VTE group with age≥60 years old,diabetes mellitus,multiple injuries and deep venous catheterization was higher than that in non-VTE group,with their operation duration and hospital stay longer than those in non-VTE group,their D-dimer level higher than that in non-VTE group,and their GCS score,platelet count and PT on admission lower than those in non-VTE group(P＜0.05).Multivariate analysis showed that age≥60 years(OR=2.408,95%CI:1.618-3.585),combined diabetes(OR=2.499,95%CI:1.672-3.735),low GCS score on admission(OR=0.325,95%CI:0.211-0.501),multiple injuries(OR=2.008,95%CI:1.422～2.835),deep venous catheterization(OR=2.147,95%CI:1.488-3.097),and elevated D-dimer level(OR=2.724,95%CI:1.784-4.159)were independent risk factors for VTE in patients with critical brain injury during hospitalization(P＜0.05).A nomogram model was then constructed to predict the occurrence of VTE in patients with critical craniocerebral injury during hospitalization.The results showed that the consistency index(C-index)was 0.817(95%CI:0.765-0.869).The area under the curve(AUC)(95%CI)was 0.884(0.832-0.936),the specificity was 68.44%,and the sensitivity was 91.82%.Conclusions The risk factors for VTE in patients with critical brain injury during hospitalization include age,diabetes mellitus,GCS score at admission,multiple injuries,deep vein catheterization,and D-dimer.The column-graph model based on this analysis has a high predictive value for VTE in patients with critical brain injury during hospitalization.