Abstract / Summary
Abstract Post-traumatic cerebrospinal fluid (CSF) rhinorrhea, a severe complication of anterior skull base fractures, is associated with significant risks of recurrence and meningitis. This retrospective study analyzed 87 patients (85 men, 2 women; mean age: 34.20 ± 15.41 years) at a tertiary care hospital (2019–2024) to identify risk factors and develop predictive models for recurrence of CSF leak, delayed meningitis, and hospital stay duration. Road traffic accidents caused 95.4% of injuries, with Class III fractures (frontal, ethmoid, and sphenoid) being most common (50.6%). Statistical analysis, including Spearman's rank correlation, Fisher's exact tests, and regression models, revealed that failed conservative management increased the risk of delayed meningitis by 18.40-fold (95% CI: 1.68–201.86). Preoperative and postoperative meningitis were significant predictors of delayed meningitis and recurrence, respectively. Severity of head injury, higher fracture class, and posterior ethmoid fractures predicted prolonged hospital stay. These findings provide risk stratification framework that may be considered pending prospective validation to reduce the risk of CSF leak recurrence and delayed meningitis.