Clinical application of non-invasive cerebral edema monitoring in acute moderate and severe brain injury: A retrospective case-control study

Objective To investigate the clinical application value of disturbance coefficient (DC), edema coefficient (EC), and intracranial pressure (ICP) with non-invasive brain edema dynamic monitoring technology for prognostic assessment of patients with acute moderate and severe brain injury (msABI). Methods A retrospective case-control study was conducted on the clinical data of 235 acute msABI patients admitted to the Department of Neurosurgery at Weifang People's Hospital from January 2024 to November 2024. All patients underwent non-invasive brain edema dynamic monitoring, with daily recordings of DC, EC, and ICP values. Correlation analysis was performed in combination with imaging midline shift, Glasgow Coma Scale (GCS) score, brain herniation, decompressive craniectomy,modus operandi, length of stay, and Glasgow Outcome Scale (GOS) score. Based on 3-month GOS score, patients were divided into a poor prognosis group (GOS 1–3) and a good prognosis group (GOS 4–5). Univariate and multivariate logistic regression analyses were used to screen independent risk factors, construct a prediction model, and evaluate its performance using the Hosmer-Lemeshow test and ROC curve. Results Correlation analysis revealed a weak positive correlation between DC and GCS and a moderate positive correlation with GOS. EC showed a moderate negative correlation with GCS and GOS. ICP exhibited a weak negative correlation with GCS and a moderate negative correlation with GOS. Univariate analysis identified statistically significant differences (p < 0.05) in decompressive craniectomy, midline shift,modus operandi, length of stay, admission GCS score, low DC values, high EC values, and high ICP values. The multivariate logistic regression model demonstrated good calibration in the Hosmer-Lemeshow test (χ²=5.105, P = 0.746). ROC curve analysis indicated that EC showed the best predictive performance for poor prognosis, with an AUC of 0.83 (95% CI 0.76–0.89), a sensitivity of 74%, and a specificity of 81% at the optimal cutoff value of 37.5. Conclusion In non-invasive brain edema monitoring technology, DC, EC, and ICP are significantly correlated with the prognosis of acute msTBI patients, with EC ≥ 37.5 serving as a critical threshold for predicting poor prognosis. The multi-parameter risk prediction model exhibits high calibration, providing a quantitative basis for early clinical intervention.