【Abstract】 Objective To establish a preliminary prediction system for progressive hemorrhage in patients with acute closed craniocerebral injury. MethodsThe clinical data of 282 patients with acute closed craniocerebral injury treated in the Emergency Department of the First Affiliated Hospital of Army Medical University from 2012 to 2020 were analyzed retrospectively. The patients were divided into progressive group (n=62) and nonprogressive group (n=220) according to the occurrence of progressive hemorrhagic injury. Chi-square test or t-test was used to compare the data of age，sex，site of injury，mechanism of injury，type of injury (Single/multiple craniocerebral injuries)，light reflex，GCS score，multiple physiological indexes and CT grading of patients between the two groups. ROC curves and multivariate Logistic regression analysis were used to determine the risk factors of progressive hemorrhage after acute closed craniocerebral injury. The prediction system for progressive hemorrhage of acute closed craniocerebral injury was established according to the value of regression coefficient β. ResultsAge (56.5 years or older)，multiple craniocerebral injuries，light reflex (retardation)，GCS score (9-12)，white blood cell (14.76×109/L or more than)，PT (11.25 s or more than)，D-dimer (10.51 mg/L or more than)，and APTT (27.4 s or more than) were independent risk factors for progressive hemorrhagic injury (P＜0.05). These variables were given specific scores and prediction system was established，and the outcome was divided into four risk stratifications：low-risk，medium-risk，high-risk，and very high-risk. ConclusionThe establishment of prediction system for progressive hemorrhage in acute closed craniocerebral injury can be used for early，convenient and accurate assessment of the injury.