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Early Systolic Dysfunction Following Traumatic Brain Injury: A Cohort Study.

Publication ,  Journal Article
Krishnamoorthy, V; Rowhani-Rahbar, A; Gibbons, EF; Rivara, FP; Temkin, NR; Pontius, C; Luk, K; Graves, M; Lozier, D; Chaikittisilpa, N ...
Published in: Crit Care Med
June 2017

OBJECTIVE: Prior studies have suggested that traumatic brain injury may affect cardiac function. Our study aims were to determine the frequency, longitudinal course, and admission risk factors for systolic dysfunction in patients with moderate-severe traumatic brain injury. DESIGN: Prospective cohort study. SETTING: Level 1 trauma center. MEASUREMENTS: Transthoracic echocardiogram within 1 day and over the first week after moderate-severe traumatic brain injury; transthoracic echocardiogram within 1 day after mild traumatic brain injury (comparison group). MEASUREMENTS AND MAIN RESULTS: Systolic function was assessed by transthoracic echocardiogram, and systolic dysfunction was defined as fractional shortening less than 25%. Multivariable Poisson regression models examined admission risk factors for systolic dysfunction. Systolic function in 32 patients with isolated moderate-severe traumatic brain injury and 32 patients with isolated mild traumatic brain injury (comparison group) was assessed with transthoracic echocardiogram. Seven (22%) moderate-severe traumatic brain injury and 0 (0%) mild traumatic brain injury patients had systolic dysfunction within the first day after injury (p < 0.01). All patients with early systolic dysfunction recovered in 1 week. Younger age (relative risk, 0.87; 95% CI, 0.79-0.94; for 1 yr increase in age) and lower admission Glasgow Coma Scale score (relative risk, 0.34; 95% CI, 0.20-0.58; for one unit increase in Glasgow Coma Scale) were independently associated with the development of systolic dysfunction among moderate-severe traumatic brain injury patients. CONCLUSIONS: Early systolic dysfunction can occur in previously healthy patients with moderate-severe traumatic brain injury, and it is reversible over the first week of hospitalization. Younger age and lower admission Glasgow Coma Scale score are independently associated with the development of systolic dysfunction after moderate-severe traumatic brain injury.

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Published In

Crit Care Med

DOI

EISSN

1530-0293

Publication Date

June 2017

Volume

45

Issue

6

Start / End Page

1028 / 1036

Location

United States

Related Subject Headings

  • Trauma Centers
  • Systole
  • Risk Factors
  • Prospective Studies
  • Middle Aged
  • Male
  • Length of Stay
  • Humans
  • Heart Diseases
  • Glasgow Coma Scale
 

Citation

APA
Chicago
ICMJE
MLA
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Krishnamoorthy, V., Rowhani-Rahbar, A., Gibbons, E. F., Rivara, F. P., Temkin, N. R., Pontius, C., … Vavilala, M. S. (2017). Early Systolic Dysfunction Following Traumatic Brain Injury: A Cohort Study. Crit Care Med, 45(6), 1028–1036. https://doi.org/10.1097/CCM.0000000000002404
Krishnamoorthy, Vijay, Ali Rowhani-Rahbar, Edward F. Gibbons, Frederick P. Rivara, Nancy R. Temkin, Crystal Pontius, Kevin Luk, et al. “Early Systolic Dysfunction Following Traumatic Brain Injury: A Cohort Study.Crit Care Med 45, no. 6 (June 2017): 1028–36. https://doi.org/10.1097/CCM.0000000000002404.
Krishnamoorthy V, Rowhani-Rahbar A, Gibbons EF, Rivara FP, Temkin NR, Pontius C, et al. Early Systolic Dysfunction Following Traumatic Brain Injury: A Cohort Study. Crit Care Med. 2017 Jun;45(6):1028–36.
Krishnamoorthy, Vijay, et al. “Early Systolic Dysfunction Following Traumatic Brain Injury: A Cohort Study.Crit Care Med, vol. 45, no. 6, June 2017, pp. 1028–36. Pubmed, doi:10.1097/CCM.0000000000002404.
Krishnamoorthy V, Rowhani-Rahbar A, Gibbons EF, Rivara FP, Temkin NR, Pontius C, Luk K, Graves M, Lozier D, Chaikittisilpa N, Kiatchai T, Vavilala MS. Early Systolic Dysfunction Following Traumatic Brain Injury: A Cohort Study. Crit Care Med. 2017 Jun;45(6):1028–1036.

Published In

Crit Care Med

DOI

EISSN

1530-0293

Publication Date

June 2017

Volume

45

Issue

6

Start / End Page

1028 / 1036

Location

United States

Related Subject Headings

  • Trauma Centers
  • Systole
  • Risk Factors
  • Prospective Studies
  • Middle Aged
  • Male
  • Length of Stay
  • Humans
  • Heart Diseases
  • Glasgow Coma Scale