title: Predictive value of early near-infrared spectroscopy monitoring of patients with traumatic brain injury.
abstract: OBJECTIVE
  Traumatic brain injury (TBI) is the leading cause of death and disability in young adults. Study aimed to define the predictive value of early near-infrared spectroscopy (NIRS) monitoring of TBI patients in a Lithuanian clinical setting.
  
  
  METHODS
  Data of 61 patients was analyzed. Predictive value of early NIRS monitoring, computed tomography data and regular intensive care unit (ICU) parameters was investigated.
  
  
  RESULTS
  Twenty-six patients expressed clinically severe TBI; 14 patients deceased. Patients who survived expressed higher NIRS values at the periods of admission to operative room (75.4%±9.8% vs. 71.0%±20.5%; P=0.013) and 1h after admission to ICU (74.7%±1.5% vs. 61.9%±19.4%; P=0.029). The NIRS values discriminated hospital mortality groups more accurately than admission GCS score, blood sugar or hemoglobin levels. Admission INR value and NIRS value at 1h after admission to ICU were selected by discriminant analysis into the optimal set of features when classifying hospital mortality groups. Average efficiency of classification using this method was 88.9%. When rsO2 values at 1h after admission to ICU did not exceed 68.0% in the left hemisphere and 68.3% in the right hemisphere, the hazard ratio for death increased by 17.7 times (P<0.01) and 5.1 times (P<0.05), respectively.
  
  
  CONCLUSIONS
  NIRS plays an important role in the clinical care of TBI patients. Regional brain saturation monitoring provides accurate predictive data, which can improve the allocation of scarce medical resources, set the treatment goals and alleviate the early communication with patients' relatives.
authors.affiliation: Department of Anesthesiology, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania; Neuroscience Institute, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania.
authors.forename: Alina
authors.initials: A
authors.lastname: Vilkė
authors.affiliation: Department of Anesthesiology, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania.
authors.forename: Diana
authors.initials: D
authors.lastname: Bilskienė
authors.affiliation: Department of Physics, Mathematics and Biophysics, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania.
authors.forename: Viktoras
authors.initials: V
authors.lastname: Šaferis
authors.affiliation: Department of Anesthesiology, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania.
authors.forename: Martynas
authors.initials: M
authors.lastname: Gedminas
authors.affiliation: Department of Anesthesiology, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania.
authors.forename: Dalia
authors.initials: D
authors.lastname: Bieliauskaitė
authors.affiliation: Neuroscience Institute, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania; Department of Neurosurgery, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania.
authors.forename: Arimantas
authors.initials: A
authors.lastname: Tamašauskas
authors.affiliation: Department of Anesthesiology, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania. Electronic address: andrius.macas@kaunoklinikos.lt.
authors.forename: Andrius
authors.initials: A
authors.lastname: Macas
mesh_terms: D000368:Aged; D001786:Blood Glucose; D001921:Brain / Q000503:physiopathology; D001930:Brain Injuries / Q000097:blood / Q000175:diagnosis* / Q000503:physiopathology; D005260:Female; D015600:Glasgow Coma Scale; D006454:Hemoglobins / Q000032:analysis; D006801:Humans; D007362:Intensive Care Units; D008297:Male; D008875:Middle Aged; D008991:Monitoring, Physiologic / Q000379:methods*; D010343:Patient Admission; D011237:Predictive Value of Tests; D019265:Spectroscopy, Near-Infrared / Q000379:methods*
chemical_list: D001786:Blood Glucose; D006454:Hemoglobins
keywords: Hospital mortality; Near-infrared spectroscopy; Traumatic brain injury