• Chunlong Ding, Shaodong Xi, Li Xiao, and Zhiyuan Qian.
• Department of Neurosurgery, The Second Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China; Department of Neurosurgery, Wuxi Branch of Zhongda Hospital Southeast University, Wuxi, Jiangsu, China.
• World Neurosurg. 2025 Jan 24: 123711123711.

ObjectiveTo investigate the risk factors and their diagnostic efficacy for postoperative intestinal mucosal barrier dysfunction (IBD) following severe traumatic brain injury (sTBI).MethodsThere were 140 patients with sTBI enrolled in this study. Univariate and multivariate logistic regression analyses were conducted to assess the relationship between the clinical data and postoperative IBD in sTBI patients and determine the independent risk factors. The diagnostic efficacy of each risk factor was evaluated using the receiver operating characteristic (ROC) curve and the area under the curve (AUC).ResultsAccording to the diagnostic criteria for IBD, the 140 enrolled patients were classified into the IBD group (n = 60) and the non-IBD group (n = 80). The levels of intraoperative initial intracranial pressure (iICP) of patients with IBD were significantly higher compared with those of patients without IBD (P < 0.001). Furthermore, intraoperative iICP presented high diagnostic efficacy for postoperative IBD (AUC = 0.91, 95% confidence interval [CI] 0.85-0.96, P < 0.001). Patients with higher intraoperative iICP were more prone to suffering unfavorable neurological outcomes.ConclusionsIntraoperative iICP could act as an independent and quantifiable predictor with high diagnostic efficacy for IBD in patients with sTBI after emergency surgery.Copyright © 2025. Published by Elsevier Inc.

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