To investigate the influencing factors of postoperative encephalocele in patients with severe traumatic brain injury (TBI), and to establish a risk prediction model for postoperative encephalocele in patients with severe TBI.

A total of 126 patients with severe TBI who were treated in Critical Medicine Department of Pidu District People’s Hospital from January 2018 to February 2020 were selected as the research objects. According to the occurrence of postoperative encephalocele, they were divided into encephalocele group and non encephalocele group. The general clinical data of the two groups were collected, and the risk factors of postoperative encephalocele in patients with severe TBI were analyzed by univariate and multivariate factors. R (R3.5.3) was used to establish a nomographic model for predicting the risk of encephalocele in patients with severe TBI after surgery.

There were 42 patients in the encephalocele group, the incidence of encephalocele was 33.33% (42/126), and 84 patients in the non-encephalocele group. Univariate analysis showed that the influencing factors of postoperative encephalocele were distal skull fracture, history of anticoagulation, hydrocephalus, intracranial infection, delayed traumatic intracranial hematoma (DTIH), post-traumatic acute diffuse brain swelling (PADBS), preoperative intracranial pressure, platelet count and prothrombin time (P<0.05). Distal skull fracture, history of anticoagulation, hydrocephalus, DTIH, PADBS, and preoperative intracranial pressure are all risk factors for postoperative encephalocele in patients with severe TBI (P<0.05); the results of the nomogram model showed that the model consistency index was 0.857 (95%CI: 0.823-0.891), the calibration curve was basically consistent with the ideal curve, and the area under the receiver operating characteristic curve was 0.848 (95%CI: 0.817-0.879).

Combination of surgically distant skull fractures, history of anticoagulation, hydrocephalus, DTIH, PADBS, and preoperative intracranial pressure are independent risk factors for postoperative encephalocele in patients with severe TBI. The risk prediction model established by the above six risk factors can help predict the risk of postoperative encephalocele in patients with severe TBI.