title: Association between electrocardiographic findings and cardiac dysfunction in adult isolated traumatic brain injury.
abstract: BACKGROUND
  Abnormal electrocardiographic (ECG) findings can be seen in traumatic brain injury (TBI) patients. ECG may be an inexpensive tool to identify patients at high risk for developing cardiac dysfunction after TBI. The aim of this study was to examine abnormal ECG findings after isolated TBI and their association with true cardiac dysfunction, based on echocardiogram.
  
  
  METHODS
  Data from adult patients with isolated TBI between 2003 and 2010 was retrospectively examined. Inclusion criteria included the presence of a 12-lead ECG within 24 h of admission and a formal echocardiographic examination within 72 h of admission after TBI. Patients with preexisting cardiac disease were excluded. Baseline clinical characteristics, 12-lead ECG, and echocardiogram report were abstracted. Logistic regression was used to identify the relationship of specific ECG abnormalities with cardiac dysfunction.
  
  
  RESULTS
  We examined data from 59 patients with isolated TBI who underwent 12-lead ECG and echocardiographic evaluation. In this cohort, 13 (22%) patients had tachycardia (heart rate >100 bpm), 25 (42.4%) patients had a prolonged QTc, and 6 (10.2%) patients had morphologic end-repolarization abnormalities (MERA), with each having an association with abnormal echocardiographic findings: Odds ratios (and 95% confidence intervals) were 4.14 (1.02-17.05), 9.0 (1.74-46.65), and 5.63 (1.96-32.94), respectively. Ischemic-like ECG changes were not associated with echocardiographic abnormalities.
  
  
  CONCLUSIONS
  Repolarization abnormalities (prolonged QTc and MERA), but not ischemic-like ECG changes, are associated with cardiac dysfunction after isolated TBI. 12-lead ECG may be an inexpensive screening tool to evaluate isolated TBI patients for cardiac dysfunction prior to more expensive or invasive studies.
authors.affiliation: Department of Anesthesiology and Pain Medicine, University of Washington, Seattle, WA, USA.
authors.forename: Vijay
authors.initials: V
authors.lastname: Krishnamoorthy
authors.affiliation: Department of Anesthesiology and Pain Medicine, University of Washington, Seattle, WA, USA.
authors.forename: Sumidtra
authors.initials: S
authors.lastname: Prathep
authors.affiliation: Department of Anesthesiology and Pain Medicine, University of Washington, Seattle, WA, USA ; Department of Neurological Surgery, University of Washington, Seattle, WA, USA.
authors.forename: Deepak
authors.initials: D
authors.lastname: Sharma
authors.affiliation: Department of Cardiology, University of Washington, Seattle, WA, USA.
authors.forename: Edward
authors.initials: E
authors.lastname: Gibbons
authors.affiliation: Department of Anesthesiology and Pain Medicine, University of Washington, Seattle, WA, USA ; Department of Neurological Surgery, University of Washington, Seattle, WA, USA ; Department of Pediatrics, University of Washington, Seattle, WA, USA ; Department of Radiology, University of Washington, Seattle, WA, USA.
authors.forename: Monica S
authors.initials: MS
authors.lastname: Vavilala
keywords: Cardiac function; electrocardiography; traumatic brain injury