Management of Cerebrospinal Fluid Leaks After Basilar Skull Fractures

Background: Cerebrospinal fluid (CSF) leaks are an uncommon but consequential effect of skull base fractures. They increase the risk for meningitis, hematomas, and herniations; however, most of them can be managed conservatively. Although, early identification and treatment is essential to prevent detrimental complications, especially in cases that require surgical repair. Few studies have explored the factors associated with the development of traumatic CSF leaks and required surgical repair. This project used data from a national database to investigate the variables that contribute to these outcomes. Methods: The national trauma data bank (NTDB) was queried from 2019 to 2023 for patients with traumatic fractures of the skull base. ICD10 codes were used to identify concurrent diagnoses and procedures for each patient. Additionally, patient demographics and injury details were extracted from the database. Linear regression models were used to identify variables with significant association with a diagnosis of CSF leak after skull base fractures, and those associated with the need for surgical repair. Results: Our data query resulted in 190,657 patients with a skull base fracture between 2019 and 2023. Of these, 6,948 (3.6%) had a traumatic CSF leak as well. 25.7% of the patients were female overall, and male sex was associated with increased rate of CSF leaks (OR 0.829; 95%CI 0.782-0.877). The average age of the participants was 41.7 +/− 21.9 years old, and a younger age was significantly correlated with CSF leaks (p-value