Complexity of intracranial pressure correlates with outcome after traumatic brain injury.
This study applied multiscale entropy analysis to investigate the correlation between the complexity of intracranial pressure waveform and outcome after traumatic brain injury. Intracranial pressure and arterial blood pressure waveforms were low-pass filtered to remove the respiratory and pulse components and then processed using a multiscale entropy algorithm to produce a complexity index. We identified significant differences across groups classified by the Glasgow Outcome Scale in intracranial pressure, pressure-reactivity index and complexity index of intracranial pressure (P < 0.0001; P = 0.001; P < 0.0001, respectively). Outcome was dichotomized as survival/death and also as favourable/unfavourable. The complexity index of intracranial pressure achieved the strongest statistical significance (F = 28.7; P < 0.0001 and F = 17.21; P < 0.0001, respectively) and was identified as a significant independent predictor of mortality and favourable outcome in a multivariable logistic regression model (P < 0.0001). The results of this study suggest that complexity of intracranial pressure assessed by multiscale entropy was significantly associated with outcome in patients with brain injury.
Division of Neurosurgery, Department of Clinical Neurosciences, University of Cambridge, Cambridge CB0 2QQ, UK.
Cheng-Wei
CW
Lu
Marek
M
Czosnyka
Jiann-Shing
JS
Shieh
Anna
A
Smielewska
John D
JD
Pickard
Peter
P
Smielewski
D000293:Adolescent; D000328:Adult; D001930:Brain Injuries / Q000503:physiopathology* / Q000628:therapy*; D015331:Cohort Studies; D005260:Female; D015600:Glasgow Coma Scale / Q000639:trends; D006801:Humans; D007427:Intracranial Pressure / Q000502:physiology*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012189:Retrospective Studies; D016896:Treatment Outcome; D055815:Young Adult