Brain Hypoxia Tied to Poor Post-Traumatic Injury Outcome

Indicative of poor prognosis independent of intracranial, perfusion pressures, severity of injury

FRIDAY, Nov. 11 (HealthDay News) -- Brain hypoxia (BH), or reduced brain oxygen (Pbto2), is independently associated with poor short-term outcomes in severe traumatic brain injury (TBI), according to a study published in the November issue of Neurosurgery.

Mauro Oddo, M.D., from the University of Pennsylvania Medical Center in Philadelphia, and colleagues analyzed the relationship between Pbto2, intracranial pressure (ICP), and cerebral perfusion pressure (CPP). A total of 103 patients with TBI who had more than 24 hours of ICP and Pbto2 monitoring were selected. The duration of BH, ICP greater than 20 mm Hg, and CPP less than 60 mm Hg were calculated and their correlations with outcome within 30 days were evaluated.

The investigators found that patients with unfavorable outcomes (Glasgow Coma Scale score, 1 to 3) had significantly longer duration of BH than those with favorable outcomes (Glasgow Coma Scale score, 4 to 5). For patients with intracranial hypertension, BH was associated with significantly fewer favorable outcomes (46 versus 81 percent). Compared to patients with low CPP and normal Pbto2, those with low CPP and BH had a significantly reduced likelihood of having a favorable outcome (39 versus 83 percent). BH was significantly and independently associated with poor prognosis after controlling for ICP, CPP, age, Glasgow Coma Scale score, Marshall computed tomography grade, and Acute Physiology and Chronic Health Evaluation II score (adjusted odds ratio for favorable outcome, 0.89 per hour of BH).

"BH is associated with poor short-term outcome after severe TBI independently of elevated ICP, low CPP, and injury severity," the authors write.

Two of the study authors disclosed financial ties to Integra Lifesciences.

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