Association between Physiological Signal Complexity and Outcomes in Moderate and Severe Traumatic Brain Injury: A CENTER-TBI Exploratory Analysis of Multi-Scale Entropy
| Autor: | Daniel Kondziella, Juan Sahuquillo, Oliver Sakowitz, Riikka Takala, Ari Ercole, Giuseppe Citerio, Rahul Raj, Andreea Rădoi, Kirsten Moller, Frederick Zeiler, Arminas Ragauskas |
|---|---|
| Přispěvatelé: | Zeiler, F, Ercole, A, Placek, M, Hutchinson, P, Stocchetti, N, Czosnyka, M, Smielewski, P, Citerio, G |
| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
Adult
Male 030506 rehabilitation medicine.medical_specialty Intracranial Pressure Traumatic brain injury Cbf autoregulation Glasgow Outcome Scale Blood Pressure Multi scale entropy 03 medical and health sciences Vascular reactivity multi-scale entropy 0302 clinical medicine Physical medicine and rehabilitation Heart Rate Brain Injuries Traumatic medicine Humans Autoregulation Monitoring Physiologic Retrospective Studies business.industry autoregulation Exploratory analysis Middle Aged medicine.disease cerebral physiology humanities Cerebrovascular Circulation Intensive Care Units outcome Female Neurology (clinical) 0305 other medical science business complexity 030217 neurology & neurosurgery |
| Popis: | In traumatic brain injury (TBI), preliminary retrospective work on signal entropy suggests an association with global outcome. The goal of this study was to provide multi-center validation of the association between multi-scale entropy (MSE) of cardiovascular and cerebral physiological signals, with six-month outcome. Using the Collaborative European NeuroTrauma Effectiveness Research in TBI (CENTER-TBI) high-resolution intensive care unit (ICU) cohort, we selected patients with a minimum of 72 h of physiological recordings and a documented six-month Glasgow Outcome Scale Extended (GOSE) score. The 10-sec summary data for heart rate (HR), mean arterial pressure (MAP), intracranial pressure (ICP), and pulse amplitude of ICP (AMP) were derived across the first 72 h of data. The MSE complexity index (MSE-Ci) was determined for HR, MAP, ICP, and AMP, with the association between MSE and dichotomized six-month outcomes assessed using Mann-Whitney U testing and logistic regression analysis. A total of 160 patients had a minimum of 72 h of recording and a documented outcome. Decreased HR MSE-Ci (7.3 [interquartile range (IQR) 5.4 to 10.2] vs. 5.1 [IQR 3.1 to 7.0]; p = 0.002), lower ICP MSE-Ci (11.2 [IQR 7.5 to 14.2] vs. 7.3 [IQR 6.1 to 11.0]; p = 0.009), and lower AMP MSE-Ci (10.9 [IQR 8.0 to 13.7] vs. 8.7 [IQR 6.6 to 11.0]; p = 0.022), were associated with death. Similarly, lower HR MSE-Ci (8.0 [IQR 6.2 to 10.9] vs. 6.2 [IQR 3.9 to 8.7]; p = 0.003) and lower ICP MSE-Ci (11.4 [IQR 8.6 to 14.4)] vs. 9.2 [IQR 6.0 to 13.5]), were associated with unfavorable outcome. Logistic regression analysis confirmed that lower HR MSE-Ci and ICP MSE-Ci were associated with death and unfavorable outcome at six months. These findings suggest that a reduction in cardiovascular and cerebrovascular system entropy is associated with worse outcomes. Further work in the field of signal complexity in TBI multi-modal monitoring is required. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|