Abstract
There are limited studies on the relationship between the vascular transcranial Doppler (TCD) pulsatility index (PI) and in-hospital mortality in patients with traumatic brain injury (TBI). To address this issue, we conducted this study to explore whether, in newly diagnosed Chinese TBI patients, the PI is an independent predictor of the in-hospital mortality rate after adjusting for other covariates. This study is a retrospective cohort study. From 24 March 2019 to 24 January 2020, we recruited 144 Chinese patients with newly diagnosed TBI from a Chinese hospital. The independent variable was the PI, and the dependent variable was in-hospital mortality in TBI patients. The relationship between the PI and in-hospital mortality in TBI patients was nonlinear and had an inflection point of 1.11. In the multivariate analysis, after adjusting for potential confounders, the effect sizes and confidence intervals per additional 0.1 units on the left and right sides of the inflection point were 4.09 (1.30–12.83) and 1.42 (0.93–2.17). The relationship between the PI and in-hospital mortality was nonlinear. The PI was positively related with in-hospital mortality when the PI was less than 1.11.
Highlights
Received: 15 January 2022traumatic brain injury (TBI) can be classified into three grades: mild, moderate, and severe
The results of the univariate analysis are(nshown did not indicate a significant association between in-hospital mortality and age, gender, diPI Tertiles abetes, hypertension, trauma time before admission, hemoglobin count, Na+ concentration, Characteristics p-Value
We constructed three models to analyze the independent effects of each variable on in-hospital mortality
Summary
TBI can be classified into three grades: mild, moderate, and severe. According to data from the World Health Organization, approximately 70–90% of TBI patients are of mild grade [1,2]. The presence of several major post-traumatic cerebral hemodynamic disturbances results in a poor prognosis of secondary craniocerebral injury. The accuracy of the traditional scaling methods for TBI severity is occasionally affected by factors such as sedation, intubation, and limb movement disorder of the patient, resulting in difficulties in clinical evaluation. Non-invasive, and reproducible method, TCD can be used as a bedside evaluation for cerebral hemodynamic changes in the intracranial arterial system. TCD has been widely used in neurosurgery patients, especially those with severe
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