Nomogram for Predicting Post-Operative Pulmonary Infection in Patients with Traumatic Intra-Cranial Hematoma

Abstract

Background:

This study sought to determine key risk factors for post-operative pulmonary infections (PPIs) in traumatic intra-cranial hematoma (TICH) patients and to develop a nomogram for evaluating infection risk.

Methods:

A retrospective analysis was performed on TICH patients at a single-center hospital between October 2014 and September 2023. Key risk factors for PPI were identified using multi-variable logistic regression analysis, which were subsequently incorporated into a nomogram. Internal validation of the model was performed to assess its reliability and accuracy.

Results:

This study included 252 TICH patients, identifying significant risk factors for PPI such as age ≥60 years (odds ratio [OR]: 3.45, 95% confidence interval [CI]: 1.89–6.78, p < 0.001), smoking history (OR: 2.95, 95% CI: 1.56–5.24, p < 0.001), Glasgow Coma Scale [GCS] score <8 (OR: 4.10, 95% CI: 2.22–8.35, p < 0.001), mechanical ventilation for more than 3 days (OR: 6.25, 95% CI: 3.35–11.75, p < 0.001), and chest injury (OR: 4.75, 95% CI: 2.49–9.16, p < 0.001). A predictive nomogram based on these factors demonstrated good discriminative power upon internal validation.

Conclusion:

Age, smoking history, GCS score, duration of mechanical ventilation, and chest injury are independent risk factors for PPI in TICH patients. The developed nomogram is a valuable tool for clinicians in predicting infection risk and guiding post-operative management.