CEREBRAL OXIMETRY AS A PREDICTOR OF THE OUTCOME OF THE DISEASE IN PATIENTS WITH SECONDARY BRAIN LESIONS

This study is devoted to the study of the prognostic value of cerebral oximetry of the brain and indicators of the outcome of brain damage. The purpose - to study the prognostic role of cerebral oximetry indicators as a predictor of mortality in vascular and traumatic brain injuries. A prospective cohort study involving 129 patients. Cerebral gas exchange and oxygenation, arteriovenous difference, neuron-specific markers (S100ß, NSE) and glucose, acid-base state and gas composition of arterial blood were studied during follow-up periods: at admission, on the 3rd, 5th and 7th days of patients' stay in the intensive care unit. The most significant risk factor for an unfavorable outcome is a marker with a threshold value or with a cut-off point rSO2<45%. Statistically significant direct connections were determined between dependent rSO2<45% with independent variables, such as: S100ß<0.6 mcg/l - OR is 4.22 (95%CI:10.76-1.66), p=0.0025; joining in a patient with a diagnosis of pneumonia - OR 6.21(95% CI:12.0-3.21), p<0.0001 and the patient's diagnosis was 8.13 (95% CI:25.59-2.59), p=0.0003. The measure of certainty of the obtained model was according to the criterion of pseudo R2 Nagelkerke -137.8; log Likelihood - 175.83. The cut-off point of 97.1% had the best predictive value of the model, the area under the AuROC curve was 0.846; sensitivity - 68.47%; specificity - 90.16%; NPV - 61.11%; PPV - 92.68%. The quantitative indicator rSO2 was obtained in relation to the independent variables GCS, ABP, NSE and pH and the quality characteristic of the model has: R2 = 16.7%; R2 (adjusted) = 15.5%; p<0.0001. This model can be used to predict the outcome in patients with acute cerebral pathology.