Advanced search
Publication Cover
Brain Injury Volume 29, 2015 - Issue 13-14
Submit an article Journal homepage
696
Views
20
CrossRef citations to date
0
Altmetric
Original Article

Predictive value of hyperthermia and intracranial hypertension on neurological outcomes in patients with severe traumatic brain injury

Brandon W. BondsShock Trauma Anesthesia Research Organized Research Center, University of Maryland School of Medicine and R Adams Cowley Shock Trauma Center, Baltimore, MD, USA, Correspondence[email protected]
,
Peter HuShock Trauma Anesthesia Research Organized Research Center, University of Maryland School of Medicine and R Adams Cowley Shock Trauma Center, Baltimore, MD, USA,
,
Yao LiShock Trauma Anesthesia Research Organized Research Center, University of Maryland School of Medicine and R Adams Cowley Shock Trauma Center, Baltimore, MD, USA,
,
Shiming YangShock Trauma Anesthesia Research Organized Research Center, University of Maryland School of Medicine and R Adams Cowley Shock Trauma Center, Baltimore, MD, USA,
,
Katharine ColtonShock Trauma Anesthesia Research Organized Research Center, University of Maryland School of Medicine and R Adams Cowley Shock Trauma Center, Baltimore, MD, USA, ;Duke University School of Medicine, Durham, NC, USA, and
,
Anish GonchigarShock Trauma Anesthesia Research Organized Research Center, University of Maryland School of Medicine and R Adams Cowley Shock Trauma Center, Baltimore, MD, USA,
,
Jerry CheriyanMarshfield Clinic, Department of Surgery, Marshfield, WI, USA
,
Thomas GrissomShock Trauma Anesthesia Research Organized Research Center, University of Maryland School of Medicine and R Adams Cowley Shock Trauma Center, Baltimore, MD, USA,
,
Raymond FangShock Trauma Anesthesia Research Organized Research Center, University of Maryland School of Medicine and R Adams Cowley Shock Trauma Center, Baltimore, MD, USA,
&
Deborah M. SteinShock Trauma Anesthesia Research Organized Research Center, University of Maryland School of Medicine and R Adams Cowley Shock Trauma Center, Baltimore, MD, USA,
show all
Pages 1642-1647 | Received 17 Nov 2014, Accepted 18 Jul 2015, Published online: 19 Oct 2015
 
Sample our Medicine, Dentistry, Nursing & Allied Health journals, sign in here to start your FREE access for 14 days

Abstract

Background: Intracranial hypertension (ICH) and hyperthermia are common after traumatic brain injury (TBI) and associated with worse neurological outcomes. This study sets out to determine the combined power of temperature and intracranial pressure (ICP) for predicting neurologic outcomes and prolonged length of stay (LOS) following severe TBI.

Methods: High resolution (every 6 seconds) temperature and ICP data were collected in adults with severe TBI from 2008–2010. Temperatures were plotted against concurrent ICP and divided based on breakpoints (Temperature: <36, 36–38.5 or >38.5 °C, ICP: <20, 20–30 or >30 mmHg). The percentage of time spent in each section, as well as several pooled unfavourable conditions (hyperthermia ± ICH), were then evaluated for predictive value for ICU-LOS > 7 days and short-term (<6 months) vs. long-term (>6 months) dichotomized neurologic outcomes.

Results: Fifty patients were included for analysis with severe TBI. Evaluation of the area under the operating receiver curve (AUC) showed significant periods of fever and high ICP (<30 mmHg) had a strong association with poor long-term neurological outcomes (Day 3, AUC = 0.71, p = 0.04) and were higher than either condition alone. ICU-LOS > 7 days was increased when hyperthermia and/or ICH remained uncontrolled by Day 5 (AUC = 0.82, p = 0.02).

Summary: Hyperthermia combined with ICH were shown to be significant prognostic indicators of future poor neurologic outcomes in patients with severe traumatic brain injury.

Acknowledgements

This work was funded in part through a grant provided by the USAF. The views expressed in this article are those of the authors and do not necessarily represent the official position or policy of the US Air Force, the Department of Defense or the US Government.

Declaration of interest

The authors report no conflicts of interest. This study is supported in part by FA8650-13-2-6D15 (ICP Comparison) and FA8650-12-2-6D09 (Fit to Fly).

Log in via your institution

Access through your institution

Log in to Taylor & Francis Online

Restore content access

Restore content access for purchases made as guest
Purchase options * Save for later

PDF download + Online access

  • 48 hours access to article PDF & online version
  • Article PDF can be downloaded
  • Article PDF can be printed
USD 65.00 Add to cart

Issue Purchase

  • 30 days online access to complete issue
  • Article PDFs can be downloaded
  • Article PDFs can be printed
USD 727.00 Add to cart

* Local tax will be added as applicable

Related Research

People also read lists articles that other readers of this article have read.

Recommended articles lists articles that we recommend and is powered by our AI driven recommendation engine.

Cited by lists all citing articles based on Crossref citations.
Articles with the Crossref icon will open in a new tab.