Key result
Cardiac dysfunction is not associated with increased hospital mortality in moderate to severe TBI.
Why the study?
There are limited data regarding the development of myocardial dysfunction after traumatic brain injury in adult ICU patients.
Cohort (n=46)
Cardiac dysfunction occurs in approximately 13% of patients with moderate to severe TBI and is associated with diabetes and ECG abnormalities, but does not appear to significantly worsen hospital mortality or length of stay.
Answers are grounded in this paper and cite their sources.
Cardiac dysfunction occurs in 13% of moderate-severe TBI ICU patients, linked to diabetes and ECG changes but not outcomes; leaves open need for larger prospective studies.
Background: There are limited data regarding the development of myocardial dysfunction after a traumatic brain injury (TBI).We investigated incidence, risk factors, and prognostic importance of cardiac dysfunction in adult patients admitted to the intensive care unit (ICU) after a moderate to severe TBI.Methods: Prospective observational study of consecutive patients admitted to neuro-trauma ICU with moderate to severe TBI from August 2014 to June 2015.Results: A total of 46 patients were included.Patients' mean (±SD) age was 44.7 (±20.7) years and mean Glasgow Coma Scale value was 5.6 (±3).Motor vehicle accident was the most common mechanism of TBI, with subdural and subarachnoid hemorrhages as the most common pathologies.Cardiac dysfunction developed in 6 of 46 (13%) patients.Patients with cardiac dysfunction had higher prevalence of diabetes mellitus (50% vs. 10%, P = 0.03) and higher proportion of electrocardiogram abnormalities (83% vs. 27%, P = 0.02) compared to the patients without cardiac dysfunction.Mean Glasgow Coma Scale scores were not significantly different between patients who developed cardiac dysfunction from those who did not (5.5 vs. 5.6, P = 0.95).Requirement for vasopressor support (33.3% vs. 40%, P = 1.0) and median ventilator days (5.2 vs. 4.7, P = 0.9) were similar between patients with and without cardiac dysfunction.There were no significant differences in hospital lengths of stay (12.3 vs. 13.8 days, P = 0.34) and hospital mortality (33% vs. 17.5%,P = 0.58) between the two groups.Conclusions: Cardiac dysfunction occurs in patients after moderate to severe TBI, with mild to moderate reduction in left ventricular ejection fraction.Patients who developed cardiac dysfunction after TBI had a higher prevalence of diabetes mellitus and higher proportion of abnormalities in electrocardiograms.Development of cardiac dysfunction was not associated with adverse clinical outcomes.
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Venkata et al. (2018) conducted a cohort in Moderate to severe traumatic brain injury (n=46). Cardiac dysfunction vs. No cardiac dysfunction was evaluated on Hospital mortality (p=0.58). In adult patients with moderate to severe traumatic brain injury, the development of cardiac dysfunction was not associated with increased hospital mortality.
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