title: Radiographic and Clinical Predictors of Cardiac Dysfunction Following Isolated Traumatic Brain Injury.
abstract: BACKGROUND
  Although cardiac dysfunction after traumatic brain injury (TBI) has been described, there is little data regarding the association of radiographic severity and particular lesions of TBI with the development of cardiac dysfunction. We hypothesize that the Rotterdam or Marshall scores and particular TBI lesions are associated with the development of cardiac dysfunction after isolated TBI.
  
  
  METHODS
  We performed a retrospective cohort study. Adult patients with isolated TBI who underwent echocardiography between 2003 and 2010 were included. A board-certified neuroradiologist assessed the first computed tomography head, assigning the Rotterdam and Marshall scores and the type of TBI. Cardiac dysfunction was defined as either systolic or all cause based on the first echocardiogram after TBI. Demographic, radiological, and clinical variables were used in our analysis.
  
  
  RESULTS
  A total of 139 patients were identified, with 20 having isolated systolic dysfunction. The Marshall and Rotterdam scores were not associated with the development of cardiac dysfunction. Only head Abbreviated Injury Scale was found to be an independent predictor of systolic cardiac dysfunction (relative risk: 2.70, 95% confidence interval: 1.19-6.13; P = .02).
  
  
  CONCLUSIONS
  No specific radiographic variable was found to be an independent predictor of cardiac dysfunction. Further study into clinical or radiological features that would warrant an echocardiogram is warranted, as it may direct patient management.
authors.affiliation: 1 Department of Anesthesiology & Pain Medicine, University of Washington, Seattle, WA, USA.
authors.forename: Alfredo E
authors.initials: AE
authors.lastname: Urdaneta
authors.affiliation: 3 Department of Radiology, University of Washington, Seattle, WA, USA.
authors.forename: Kathleen R
authors.initials: KR
authors.lastname: Fink
authors.affiliation: 1 Department of Anesthesiology & Pain Medicine, University of Washington, Seattle, WA, USA.
authors.forename: Vijay
authors.initials: V
authors.lastname: Krishnamoorthy
authors.affiliation: 2 Department of Epidemiology, University of Washington, Seattle, WA, USA.
authors.forename: Ali
authors.initials: A
authors.lastname: Rowhani-Rahbar
authors.affiliation: 1 Department of Anesthesiology & Pain Medicine, University of Washington, Seattle, WA, USA.
authors.forename: Monica S
authors.initials: MS
authors.lastname: Vavilala
mesh_terms: D000368:Aged; D015415:Biomarkers / Q000097:blood; D000070642:Brain Injuries, Traumatic / Q000097:blood / Q000150:complications* / Q000000981:diagnostic imaging / Q000503:physiopathology; D052279:Creatine Kinase, MB Form / Q000097:blood; D003422:Critical Care / Q000379:methods; D004452:Echocardiography; D005260:Female; D006333:Heart Failure / Q000097:blood / Q000000981:diagnostic imaging / Q000209:etiology* / Q000503:physiopathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000097:blood; D012189:Retrospective Studies; D012720:Severity of Illness Index; D013318:Stroke Volume; D014057:Tomography, X-Ray Computed; D019210:Troponin I / Q000097:blood; D014481:United States
chemical_list: D015415:Biomarkers; D019210:Troponin I; D020097:Natriuretic Peptide, Brain; D052279:Creatine Kinase, MB Form
keywords: Marshall score; Rotterdam score; age; brain injury; cardiac dysfunction; cardiac output; computed tomography; critical care; heart brain interaction; injury severity; neurocritical care; neurogenic-mediated cardiac dysfunction; radiologic predictors; subdural hemorrhage; traumatic brain injury