Objective To investigate the value of cranial CT cisternal grading combined with D-dimer (D-D) and Glasgow Coma Scale (GCS) score in predicting the short-term postoperative prognosis of patients with severe traumatic brain injury.

Methods A total of 165 patients with severe traumatic brain injury who were treated in the hospital from January 2019 to May 2024 were selected as study subjects, all underwent craniotomy surgery. Postoperative follow-up was conducted for 3 months to analyze the differences in clinical data and preoperative indicators such as cranial CT cisternal grading, D-D levels, and GCS scores between patients with poor and good prognosis. The value of cranial CT cisternal grading, D-D levels, and GCS scores in predicting short-term postoperative poor prognosis in patients with severe traumatic brain injury was also analyzed.

Results Compared with patients with good prognosis, patients with poor prognosis had higher proportion of age, cranial CT cisternal grading of Ⅰ to Ⅱ, D-D levels, and GCS scores < 6 (P < 0.05). There were no statistically significant differences in C-reactive protein, prothrombin time, activated partial thromboplastin time, international normalized ratio, total cholesterol, triglycerides, high-density lipoprotein cholesterol, and low-density lipoprotein cholesterol levels between patients with poor and good prognosis (P>0.05). Cranial CT cisternal grading, D-D levels, and GCS scores were influencing factors for short-term postoperative poor prognosis in patients with severe traumatic brain injury (P < 0.05). The area under the curve for poor prognosis by three indicators in combination was 0.941 (95%CI, 0.906 to 0.975), which was higher than the area under the curve for the individual predictions of cranial CT cisternal grading, D-D levels, and GCS scores (P < 0.05).

Conclusion The influencing factors for short-term postoperative prognosis in patients with severe traumatic brain injury include cranial CT cisternal grading, D-D levels, and GCS scores. The model based on these three indicators has certain application value in predicting patient prognosis.