Comparisons of acute physiological parameters influencing outcome in patients with traumatic brain injury and hemorrhagic stroke.
BACKGROUND
Although several factors are known to influence prognosis after acute brain injury, physiologic derangements were found to be associated with, or contributing to, increased mortality and disability in these patients.


OBJECTIVE
This study was conducted to identify acute physiological parameters that significantly predict outcome and compare the identified parameters in patients with traumatic brain injury (TBI) and hemorrhagic stroke.


METHODS
Participants were 190 adult patients with TBI or hemorrhagic stroke who were admitted within 24 hours of injury. Details concerning potential physiological predictors were collected, that is, blood pressure (BP), heart rate, respiratory rate, body temperature, hematocrit, partial pressure of oxygen and carbon dioxide in arterial blood, serum osmolality, pH, total cholesterol, and glucose levels on admission. Mortality and functional and cognitive ability 6 months after injury were measured as outcome variables.


RESULTS
Most physiological parameters, with the exceptions of blood glucose, total cholesterol, and osmolality, were significant prognostic predictors in TBI and hemorrhagic stroke. However, the physiological parameters and their predictabilities differed in patients with TBI and hemorrhagic stroke, which indicated that physiological predictors depend on chosen outcome and brain injury type.


CONCLUSIONS
In critical care units, the most important aims of nursing care are decreasing mortality and disability rates. In order to achieve such goals, acute physiological parameters such as BP, respiratory rate, heart rate, PaO2, PaCO2, and temperature should be monitored and managed, with the aim of reducing the risk of secondary brain injury.
Seo
WhaSook
W
Department of Nursing, College of Medicine, Inha University, Incheon, Republic of Korea. wschang@inha.ac.kr
Oh
HyunSoo
H
D000328:Adult; D000368:Aged; D001794:Blood Pressure; D001831:Body Temperature; D001930:Brain Injuries / Q000401:mortality* / Q000503:physiopathology* / Q000628:therapy; D002245:Carbon Dioxide / Q000097:blood; D002543:Cerebral Hemorrhage / Q000401:mortality* / Q000503:physiopathology* / Q000628:therapy; D004185:Disability Evaluation; D005260:Female; D006339:Heart Rate; D006801:Humans; D008297:Male; D008875:Middle Aged; D010100:Oxygen / Q000097:blood; D011237:Predictive Value of Tests; D011379:Prognosis; D015656:Respiratory Mechanics; D020521:Stroke / Q000401:mortality* / Q000503:physiopathology* / Q000628:therapy; D016896:Treatment Outcome
D002245:Carbon Dioxide; D010100:Oxygen