Complexity of intracranial pressure correlates with outcome after traumatic brain injury

被引:63
|
作者
Lu, Cheng-Wei [1 ,2 ,3 ]
Czosnyka, Marek [1 ]
Shieh, Jiann-Shing [3 ]
Smielewska, Anna [4 ]
Pickard, John D. [1 ]
Smielewski, Peter [1 ]
机构
[1] Univ Cambridge, Div Neurosurg, Dept Clin Neurosci, Cambridge CB0 2QQ, England
[2] Far Eastern Mem Hosp, Dept Anaesthesiol, Taipei 220, Taiwan
[3] Yuan Ze Univ, Dept Mech Engn, Tao Yuan 220, Taiwan
[4] Addenbrookes Hosp, Publ Hlth Lab, Dept Virol, Cambridge CB0 2QQ, England
基金
英国医学研究理事会;
关键词
complexity; intracranial pressure; multiscale entropy; traumatic brain injury; outcome; MULTISCALE ENTROPY ANALYSIS; HEART-RATE-VARIABILITY; APPROXIMATE ENTROPY; BLOOD-PRESSURE; PLATEAU WAVES; TIME-SERIES; AUTOREGULATION; HYPERTENSION; DYNAMICS; SYSTEM;
D O I
10.1093/brain/aws155
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
This study applied multiscale entropy analysis to investigate the correlation between the complexity of intracranial pressure waveform and outcome after traumatic brain injury. Intracranial pressure and arterial blood pressure waveforms were low-pass filtered to remove the respiratory and pulse components and then processed using a multiscale entropy algorithm to produce a complexity index. We identified significant differences across groups classified by the Glasgow Outcome Scale in intracranial pressure, pressure-reactivity index and complexity index of intracranial pressure (P < 0.0001; P = 0.001; P < 0.0001, respectively). Outcome was dichotomized as survival/death and also as favourable/unfavourable. The complexity index of intracranial pressure achieved the strongest statistical significance (F = 28.7; P < 0.0001 and F = 17.21; P < 0.0001, respectively) and was identified as a significant independent predictor of mortality and favourable outcome in a multivariable logistic regression model (P < 0.0001). The results of this study suggest that complexity of intracranial pressure assessed by multiscale entropy was significantly associated with outcome in patients with brain injury.
引用
收藏
页码:2399 / 2408
页数:10
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