ABSTRACT
Objective To explore risk factors for developing neurogenic heterotopic ossification (NHO) after traumatic brain injury (TBI).Methods Thirty-three patients suffering from TBI no more than 6 months and admitted to Guangdong Work Injury Rehabilitation Hospital between December 2015 and December 2016 were selected.Those with and without NHO was assigned to an NHO group (n =12) and a control group (n =21) respectively.The two groups were compared in terms of the duration of coma and mechanical ventilation,the time to start rehabilitation and the occurrence of infection,pressure ulceration,deep vein thrombosis (DVT) or inflammation.Muscle tension,white blood cell (WBC) count,erythrocyte sedimentation rate (ESR),high sensitivity creactive protein (hsCRP) and alkaline phosphatase (ALP) were also measured.Independent sample T tests,chi-squared tests and binary logistic regression were used to compare the two groups seeking to isolate risk factors for NHO which might be predictive.Results Significantly prolonged coma and/or mechanical ventilation were observed in NHO group compared to the control group.Significant differences were also found in the average WBC,ESR,hsCRP and ALP levels,as well as in the occurrence of infection,DVT and inflammatory symptoms between the two groups.The incidences of infection,DVT and inflammatory reaction were higher in the NHO group,as were the levels of leukocyte,ESR,hsCRP and ALP.Those differences between the groups were statistically (and of course clinically) significant.The duration of coma and mechanical ventilation,infection,DVT,inflammation,and elevated levels of leukocytes,ESR or ALP can all usefully be considered risk factors for NHO,with infection,DVT and inflammation of the highest importance.Conclusion Duration of coma and utilization of mechanical ventilation,infection,DVT,inflammation,as well as an increase of leukocytes,ESR or ALP should be considered as risk factors for NHO after TBI.