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Association between Cerebrovascular Reactivity Monitoring and Mortality Is Preserved When Adjusting for Baseline Admission Characteristics in Adult Traumatic Brain Injury: A CENTER-TBI Study

Sundstrom N; Beqiri E; Beer R; Czeiter E; Piippo-Karjalainen A; Depreitere B; Vargiolu A; Buki A; Steyerberg EW; Czosnyka M; Rossaint R; Menon DK; Kondziella D; Maas AIR; Stevanovic A; Thelin EP; Frisvold S; Meyfroidt G; Bellander BM; Vajkoczy P; Takala R; Sakowitz O; Radoi A; Smielewski P; Ragauskas A; Citerio G; Vilcinis R; Jankowski S; Rhodes J; Koskinen LO; Chieregato A; Younsi A; Tenovuo O; Zeiler FA; Anke A; Rocka S; Nelson D; Sahuquillo J; Helbok R; Moeller K; Ercole A; Wolf S; Chevallard G; Stocchetti N; Eapen G; Cabeleira M; Tamosuitis T; Raj R

dc.contributor.authorSundstrom N
dc.contributor.authorBeqiri E
dc.contributor.authorBeer R
dc.contributor.authorCzeiter E
dc.contributor.authorPiippo-Karjalainen A
dc.contributor.authorDepreitere B
dc.contributor.authorVargiolu A
dc.contributor.authorBuki A
dc.contributor.authorSteyerberg EW
dc.contributor.authorCzosnyka M
dc.contributor.authorRossaint R
dc.contributor.authorMenon DK
dc.contributor.authorKondziella D
dc.contributor.authorMaas AIR
dc.contributor.authorStevanovic A
dc.contributor.authorThelin EP
dc.contributor.authorFrisvold S
dc.contributor.authorMeyfroidt G
dc.contributor.authorBellander BM
dc.contributor.authorVajkoczy P
dc.contributor.authorTakala R
dc.contributor.authorSakowitz O
dc.contributor.authorRadoi A
dc.contributor.authorSmielewski P
dc.contributor.authorRagauskas A
dc.contributor.authorCiterio G
dc.contributor.authorVilcinis R
dc.contributor.authorJankowski S
dc.contributor.authorRhodes J
dc.contributor.authorKoskinen LO
dc.contributor.authorChieregato A
dc.contributor.authorYounsi A
dc.contributor.authorTenovuo O
dc.contributor.authorZeiler FA
dc.contributor.authorAnke A
dc.contributor.authorRocka S
dc.contributor.authorNelson D
dc.contributor.authorSahuquillo J
dc.contributor.authorHelbok R
dc.contributor.authorMoeller K
dc.contributor.authorErcole A
dc.contributor.authorWolf S
dc.contributor.authorChevallard G
dc.contributor.authorStocchetti N
dc.contributor.authorEapen G
dc.contributor.authorCabeleira M
dc.contributor.authorTamosuitis T
dc.contributor.authorRaj R
dc.date.accessioned2022-10-27T11:53:31Z
dc.date.available2022-10-27T11:53:31Z
dc.identifier.urihttps://www.utupub.fi/handle/10024/155695
dc.description.abstractCerebral autoregulation, as measured using the pressure reactivity index (PRx), has been related to global patient outcome in adult patients with traumatic brain injury (TBI). To date, this has been documented without accounting for standard baseline admission characteristics and intracranial pressure (ICP). We evaluated this association, adjusting for baseline admission characteristics and ICP, in a multi-center, prospective cohort. We derived PRx as the correlation between ICP and mean arterial pressure in prospectively collected multi-center data from the High-Resolution Intensive Care Unit (ICU) cohort of the Collaborative European NeuroTrauma Effectiveness Research in TBI (CENTER-TBI) study. Multi-variable logistic regression models were analyzed to assess the association between global outcome (measured as either mortality or dichotomized Glasgow Outcome Score-Extended [GOSE]) and a range of covariates (IMPACT [International Mission for Prognosis and Analysis of Clinical Trials] Core and computed tomography [CT] variables, ICP, and PRx). Performance of these models in outcome association was compared using area under the receiver operating curve (AUC) and Nagelkerke's pseudo-R-2. One hundred ninety-three patients had a complete data set for analysis. The addition of percent time above threshold for PRx improved AUC and displayed statistically significant increases in Nagelkerke's pseudo-R-2 over the IMPACT Core and IMPACT Core + CT models for mortality. The addition of PRx monitoring to IMPACT Core +/- CT + ICP models accounted for additional variance in mortality, when compared to models with IMPACT Core +/- CT + ICP alone. The addition of cerebrovascular reactivity monitoring, through PRx, provides a statistically significant increase in association with mortality at 6 months. Our data suggest that cerebrovascular reactivity monitoring may provide complementary information regarding outcomes in TBI.
dc.language.isoen
dc.publisherMARY ANN LIEBERT, INC
dc.titleAssociation between Cerebrovascular Reactivity Monitoring and Mortality Is Preserved When Adjusting for Baseline Admission Characteristics in Adult Traumatic Brain Injury: A CENTER-TBI Study
dc.identifier.urnURN:NBN:fi-fe2021042821753
dc.relation.volume37
dc.contributor.organizationfi=anestesiologia ja tehohoito|en=Anaesthesiology, Intensive Care, Emergency Care and Pain Medicine|
dc.contributor.organizationfi=tyks, vsshp|en=tyks, vsshp|
dc.contributor.organizationfi=kliiniset neurotieteet|en=Clinical Neurosciences|
dc.contributor.organization-code2607301
dc.contributor.organization-code2607314
dc.converis.publication-id44337335
dc.converis.urlhttps://research.utu.fi/converis/portal/Publication/44337335
dc.format.pagerange1241
dc.format.pagerange1233
dc.identifier.eissn1557-9042
dc.identifier.jour-issn0897-7151
dc.okm.affiliatedauthorTenovuo, Olli
dc.okm.affiliatedauthorTakala, Riikka
dc.okm.affiliatedauthorDataimport, tyks, vsshp
dc.okm.discipline3124 Neurologia ja psykiatriafi_FI
dc.okm.discipline3126 Surgery, anesthesiology, intensive care, radiologyen_GB
dc.okm.discipline3126 Kirurgia, anestesiologia, tehohoito, radiologiafi_FI
dc.okm.discipline3124 Neurology and psychiatryen_GB
dc.okm.internationalcopublicationinternational co-publication
dc.okm.internationalityInternational publication
dc.okm.typeJournal article
dc.publisher.countryYhdysvallat (USA)fi_FI
dc.publisher.countryUnited Statesen_GB
dc.publisher.country-codeUS
dc.relation.doi10.1089/neu.2019.6808
dc.relation.ispartofjournalJournal of Neurotrauma
dc.relation.issue10
dc.year.issued2020


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