Risk factors for hypostatic pneumonia in patients with severe traumatic brain injury undergoing tracheotomy
DU Jianxiong
WANG Zhenzhen
CHENG Xiaobin
LU Zhenhua
Abstract：Objective To explore the risk factors for hypostatic pneumonia in patients with severe traumatic brain injury(sTBI)undergoing tracheotomy.Methods A total of 113 patients with sTBI who underwent tracheotomy in the Department of Intensive Care Medicine at Hubei Provincial Hospital of TCM(Hubei Shizhen Laboratory/Affiliated Hospital of Hubei University of Chinese Medicine)from June 2021 to June 2024 were retrospectively selected as the study subjects.According to the occurrence of hypostatic pneumonia,the patients were divided into pneumonia group(n=27)and control group(n=86).Multivariate logistic regression analysis was used to identify independent risk factors for hypostatic pneumonia in patients with sTBI,and a risk prediction model was constructed.Homser-Lemeshow test was used to evaluate the goodness of fit of the prediction model,and the receiver operating characteristic(ROC)curve was used to evaluate its predictive performance.Results The incidence of hypostatic pneumonia in this study was 23.89%(27/113).The proportions of patients with chronic respiratory diseases,Glasgow coma scale(GCS)score≤5,non-prone bed rest posture,and hypoalbuminemia in the pneumonia group were higher than those in the control group,and the differences were statistically significant(P<0.05).Multivariate logistic regression analysis showed that GCS score≤5 and hypoalbuminemia were independent risk factors for hypostatic pneumonia in patients with sTBI undergoing tracheotomy,while prone bed rest posture was a protective factor(P<0.05).A prediction model was constructed as follows:Logistic(P)=1.540-1.185×GCS score+1.206×bed rest posture-1.993×hypoalbuminemia.Homser-Lemeshow goodness of fit test showed 2=7.314,P>0.05.ROC curve analysis showed that the AUC,sensitivity and specificity of the prediction model were 0.837(95%CI:0.762-0.912),66.67%and 81.40%.Conclusions GCS score,hypoalbuminemia,and bed rest posture are factors influencing the occurrence of hypostatic pneumonia in patients with sTBI undergoing tracheotomy.The prediction model constructed on these factors can be used to predict the occurrence of hypostatic pneumonia in patients with sTBI undergoing tracheotomy.
Keywords：traumatic brain injurytracheotomyhypostatic pneumoniarisk factor
Publication Date：2025-10-28
Online Publishing Date：2025-10-09(First online date of this platform, not the publication date of the document)
Pages：5( 127-131 )