Shock index and its variants as predictors of mortality in severe traumatic brain injury  

作　　者：Randhall B Carteri Mateus Padilha Silvaine Sasso de Quadros Eder Kroeff Cardoso Mateus Grellert 

机构地区：[1]Department of Nutrition,Centro Universitário CESUCA,Porto Alegre 94935-630,Brazil [2]Department of Analysis and Systems Development,Centro Universitário CESUCA,Porto Alegre 94935-630,Brazil [3]Department of Nutrition,Hospital Pronto Socorro de Porto Alegre,Porto Alegre 90040-192,Rio Grande do Sul,Brazil [4]Department of Physiotherapy,Hospital Pronto Socorro de Porto Alegre,Porto Alegre 90040-192,Rio Grande do Sul,Brazil [5]Institute of Informatics,Federal University of Rio Grande do Sul(UFRGS),Porto Alegre 91501-970,Rio Grande do Sul,Brazil

出　　处：《World Journal of Critical Care Medicine》2024年第1期40-48,共9页世界重症医学杂志

摘　　要：BACKGROUND The increase in severe traumatic brain injury(sTBI)incidence is a worldwide phenomenon,resulting in a heavy disease burden in the public health systems,specifically in emerging countries.The shock index(SI)is a physiological parameter that indicates cardiovascular status and has been used as a tool to assess the presence and severity of shock,which is increased in sTBI.Considering the high mortality of sTBI,scrutinizing the predictive potential of SI and its variants is vital.AIM To describe the predictive potential of SI and its variants in sTBI.METHODS This study included 71 patients(61 men and 10 women)divided into two groups:Survival(S;n=49)and Non-survival(NS;n=22).The responses of blood pressure and heart rate(HR)were collected at admission and 48 h after admission.The SI,reverse SI(rSI),rSI multiplied by the Glasgow Coma Score(rSIG),and Age multiplied SI(AgeSI)were calculated.Group comparisons included Shapiro-Wilk tests,and independent samples t-tests.For predictive analysis,logistic regression,receiver operator curves(ROC)curves,and area under the curve(AUC)measurements were performed.RESULTS No significant differences between groups were identified for SI,rSI,or rSIG.The AgeSI was significantly higher in NS patients at 48 h following admission(S:26.32±14.2,and NS:37.27±17.8;P=0.016).Both the logistic regression and the AUC following ROC curve analysis showed that only AgeSI at 48 h was capable of predicting sTBI outcomes.CONCLUSION Although an altered balance between HR and blood pressure can provide insights into the adequacy of oxygen delivery to tissues and the overall cardiac function,only the AgeSI was a viable outcome-predictive tool in sTBI,warranting future research in different cohorts.

关 键 词：Head trauma Critical patient Neuro-cardio axis Predictive tool Clinical practice 

分 类 号：R473[医药卫生—护理学]