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Observational Study
. 2018 Dec;16(3-4):57-65.
doi: 10.3121/cmr.2018.1437.

Cardiac Dysfunction in Adult Patients with Traumatic Brain Injury: A Prospective Cohort Study

Chakradhar Venkata, Jan Kasal  1
Affiliations
Observational Study

Cardiac Dysfunction in Adult Patients with Traumatic Brain Injury: A Prospective Cohort Study

Chakradhar Venkata et al. Clin Med Res. 2018 Dec.

Abstract

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.

Keywords: Cardiac dysfunction; Traumatic brain injury.

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Figures

Figure 1
Figure 1
Patient enrollment flow diagram.
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References

    1. Dimant J, Grob D. Electrocardiographic changes and myocardial damage in patients with acute cerebrovascular accidents. Stroke. 1977;8(4):448–455. - PubMed
    1. Mayer SA, Lin J, Homma S, et al. Myocardial injury and left ventricular performance after subarachnoid hemorrhage. Stroke. 1999;30(4):780–786. - PubMed
    1. Prathep S, Sharma D, Hallman M, et al. Preliminary report on cardiac dysfunction after isolated traumatic brain injury. Crit Care Med. 2014;42(1):142–147. - PMC - PubMed
    1. Krishnamoorthy V, Rowhani-Rahbar A, Gibbons EF, et al. Early Systolic Dysfunction Following Traumatic Brain Injury: A Cohort Study. Crit Care Med. 2017;45(6):1028–1036. - PMC - PubMed
    1. Cuisinier A, Maufrais C, Payen JF, Nottin S, Walther G, Bouzat P. Myocardial function at the early phase of traumatic brain injury: a prospective controlled study. Scand J Trauma Resusc Emerg Med. 2016;24(1):129. - PMC - PubMed

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