High early phase hemoglobin level is associated with favorable neurological outcome in patients with severe traumatic brain injury - 28/05/21
, Kentaro Nakamura, MD b, 1, Yasuhiro Kuroda, MD, PhD b, Kenya Kawakita, MD, PhD b, Motoki Fujita, MD, PhD c, Susumu Yamashita, MD, PhD d, Kenji Dohi, MD, PhD e, Hitoshi Kobata, MD, PhD f, Eiichi Suehiro, MD, PhD c, Tsuyoshi Maekawa, MD, PhD gon behalf of the
Brain Hypothermia (B-HYPO) Study Group in Japan
Abstract |
Background |
The appropriate hemoglobin (Hb) level threshold for the early phase (i.e. from Emergency Department to ICU admission) in patients with severe traumatic brain injury (TBI) is still unknown. Therefore, we aimed to examine the association between Hb levels during the early phase and neurological outcomes in patients with severe TBI using data from the Brain Hypothermia (B-HYPO) Study Group.
Methods |
We performed a post-hoc analysis of the B-HYPO study (a prospective, multicenter, randomized controlled trial on patients with severe TBI who received either mild therapeutic hypothermia [MTH; 32.0 °C–34.0 °C] or fever control [35.5 °C–37.0 °C]). We calculated Hb levels during early phase by the formula: (admission Hb + Hb on day 1) / 2. The primary outcome was the association between during early phase Hb levels and 6-month neurological outcome after the TBI based on the Glasgow Outcome Scale scores (a measure of functional recovery defined as moderate disability or good recovery).
Results |
We reviewed data from 130 patients and found favorable neurological outcomes in 48.5% of them. We found significant differences between the favorable and unfavorable neurological outcome groups in terms of their Hb levels on admission and on day 1. But, we found no Hb level differences after day 3 (including 1 day after rewarming). Our multivariable analysis showed that Hb levels during early phase were significantly associated with favorable neurological outcomes (odds ratio, 1.387; 95% confidence interval, 1.057–1.858; P = 0.018).
Conclusions |
High early phase Hb levels are associated with favorable neurological outcomes after severe TBI.
Le texte complet de cet article est disponible en PDF.Keywords : Hemoglobin, Traumatic brain injury, Glasgow Outcome Scale
Plan
Vol 44
P. 373-377 - juin 2021 Retour au numéro
Article précédent
- The prognostic value of routine coagulation tests for patients with heat stroke
- Ling Xing, Shu-Yuan Liu, Han-Ding Mao, Kai-Guo Zhou, Qing Song, Qiu-Mei Cao
- Fill rates and access to self-injectable epinephrine prescribed in a pediatric emergency department
- William C. Sokoloff, Nicole C. O'Connell, Prasra G. Olson, Daniel M. Fein
Bienvenue sur EM-consulte, la référence des professionnels de santé.
L’accès au texte intégral de cet article nécessite un abonnement.
Déjà abonné à cette revue ?