Predictive value of hyperthermia and intracranial hypertension on neurological outcomes in patients with severe traumatic brain injury
| Autor: | Thomas E. Grissom, Shiming Yang, Anish Gonchigar, Brandon W. Bonds, Yao Li, Jerry Cheriyan, Deborah M. Stein, Katharine Colton, Peter Hu, Raymond Fang |
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| Rok vydání: | 2015 |
| Předmět: |
Adult
Male Hyperthermia Fever Traumatic brain injury Neuroscience (miscellaneous) Diagnostic Techniques Neurological Glasgow Outcome Scale High resolution Developmental and Educational Psychology medicine Humans Glasgow Coma Scale In patient Aged Intracranial pressure business.industry musculoskeletal neural and ocular physiology Middle Aged Prognosis medicine.disease Predictive value nervous system diseases Treatment Outcome nervous system Brain Injuries Anesthesia Female Neurology (clinical) Intracranial Hypertension business |
| Zdroj: | Brain Injury. 29:1642-1647 |
| ISSN: | 1362-301X 0269-9052 2008-2010 |
| DOI: | 10.3109/02699052.2015.1075157 |
| Popis: | Intracranial hypertension (ICH) and hyperthermia are common after traumatic brain injury (TBI) and associated with worse neurological outcomes. This study sets out to determine the combined power of temperature and intracranial pressure (ICP) for predicting neurologic outcomes and prolonged length of stay (LOS) following severe TBI.High resolution (every 6 seconds) temperature and ICP data were collected in adults with severe TBI from 2008-2010. Temperatures were plotted against concurrent ICP and divided based on breakpoints (Temperature:36, 36-38.5 or38.5 °C, ICP:20, 20-30 or30 mmHg). The percentage of time spent in each section, as well as several pooled unfavourable conditions (hyperthermia ± ICH), were then evaluated for predictive value for ICU-LOS 7 days and short-term (6 months) vs. long-term (6 months) dichotomized neurologic outcomes.Fifty patients were included for analysis with severe TBI. Evaluation of the area under the operating receiver curve (AUC) showed significant periods of fever and high ICP (30 mmHg) had a strong association with poor long-term neurological outcomes (Day 3, AUC = 0.71, p = 0.04) and were higher than either condition alone. ICU-LOS 7 days was increased when hyperthermia and/or ICH remained uncontrolled by Day 5 (AUC = 0.82, p = 0.02).Hyperthermia combined with ICH were shown to be significant prognostic indicators of future poor neurologic outcomes in patients with severe traumatic brain injury. |
| Databáze: | OpenAIRE |
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