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Early Systolic Dysfunction Following Traumatic Brain Injury: A Cohort Study
Vijay Krishnamoorthy1, Ali Rowhani-Rahbar, Edward F Gibbons
11Department of Anesthesiology and Pain Medicine, University of Washington, Seattle, WA. 2Department of Epidemiology, University of Washington, Seattle, WA. 3Harborview Injury Prevention and Research Center, University of Washington, Seattle, WA. 4Department of Medicine, Division of Cardiology, University of Washington, Seattle, WA. 5Department of Pediatrics, University of Washington, Seattle, WA. 6Department of Neurosurgery, University of Washington, Seattle, WA. 7Department of Biostatistics, University of Washington, Seattle, WA. 8Georgetown University School of Medicine, Washington, DC.
Traumatic brain injury can cause temporary systolic dysfunction in patients, which usually resolves within a week. Younger age and lower Glasgow Coma Scale scores are linked to developing this cardiac issue after moderate-severe brain injury.
Area of Science:
- Cardiology
- Neurology
- Trauma Care
Background:
- Traumatic brain injury (TBI) is known to impact various physiological systems.
- Cardiac dysfunction following TBI is an area of growing clinical concern.
- Prior research suggests a potential link between TBI and cardiac function alterations.
Purpose of the Study:
- To investigate the occurrence and progression of systolic dysfunction after moderate-severe TBI.
- To identify risk factors associated with developing systolic dysfunction upon admission in TBI patients.
- To compare cardiac function in moderate-severe TBI patients with a mild TBI cohort.
Main Methods:
- A prospective cohort study was conducted at a Level 1 trauma center.
- Transthoracic echocardiograms were performed within 24 hours and during the first week post-injury for moderate-severe TBI.
- A comparison group of mild TBI patients underwent echocardiography within 24 hours.
Main Results:
- Seven (22%) moderate-severe TBI patients exhibited systolic dysfunction (fractional shortening < 25%) within 24 hours, compared to 0% in the mild TBI group (p < 0.01).
- All patients with early systolic dysfunction demonstrated recovery within one week.
- Younger age and lower admission Glasgow Coma Scale scores were independent predictors of systolic dysfunction in moderate-severe TBI.
Conclusions:
- Early-onset systolic dysfunction is a potential complication in patients with moderate-severe TBI.
- This cardiac dysfunction appears to be transient and reversible within the first week of hospitalization.
- Admission Glasgow Coma Scale score and patient age are significant risk factors for developing systolic dysfunction post-TBI.