title: Association between the outcome of traumatic brain injury patients and cerebrovascular autoregulation, cerebral perfusion pressure, age, and injury grades.
abstract: OBJECTIVE
  The aim of this study was to explore the association of cerebrovascular autoregulation (CA) and optimal cerebral perfusion pressure (CPP) managing conditions with the outcome of traumatic brain injury (TBI) patients including additional information about the patients' age and grade of diffuse axonal injury (DAI).
  
  
  METHODS
  The CA monitoring of 28 TBI patients was performed by using ICM+ software (Cambridge, UK). The CA status estimating pressure reactivity indexes (PRx) and CPP data were processed in order to obtain information on the patient-specific treatment conditions by calculating the optimal CPP.
  
  
  RESULTS
  There was a negative correlation between the Glasgow outcome scale (GOS) score and PRx (r=-0.448 at hospital discharge and r=-0.402 after 6 months). The estimated threshold value PRx of >0.24 was associated with mortality. The correlation coefficients between the GOS score and the difference CPP-optimal CPP were 0.549 at hospital discharge and 0.484 after 6 months. The threshold value of CPP declination from ΔCPPopt per -6mmHg was associated with mortality. Poorer outcome was predicted for elderly TBI patients (aged >47 years) and patients having a DAI grade of 3.
  
  
  CONCLUSIONS
  The association of the GOS score with CPP, CA impairment conditions, age and diffuse axonal injury (DAI) grade showed that the outcomes of TBI patients were associated with patient-specific CPP management and better outcomes were obtained for younger patients, for patients having lower DAI grade and for patients whose CPP was kept within the range from the optimal CPP to the optimal CPP+10mmHg.
authors.affiliation: Health Telematics Science Institute, Kaunas University of Technology, Kaunas, Lithuania. Electronic address: vytautas.petkus@ktu.lt.
authors.forename: Vytautas
authors.initials: V
authors.lastname: Petkus
authors.affiliation: Health Telematics Science Institute, Kaunas University of Technology, Kaunas, Lithuania.
authors.forename: Solventa
authors.initials: S
authors.lastname: Krakauskaitė
authors.affiliation: Centre of Neuroangiosurgery, Clinic of Neurology and Neurosurgery, Faculty of Medicine, Vilnius University, Vilnius, Lithuania.
authors.forename: Aidanas
authors.initials: A
authors.lastname: Preikšaitis
authors.affiliation: Centre of Neuroangiosurgery, Clinic of Neurology and Neurosurgery, Faculty of Medicine, Vilnius University, Vilnius, Lithuania.
authors.forename: Saulius
authors.initials: S
authors.lastname: Ročka
authors.affiliation: Health Telematics Science Institute, Kaunas University of Technology, Kaunas, Lithuania.
authors.forename: Romanas
authors.initials: R
authors.lastname: Chomskis
authors.affiliation: Health Telematics Science Institute, Kaunas University of Technology, Kaunas, Lithuania.
authors.forename: Arminas
authors.initials: A
authors.lastname: Ragauskas
mesh_terms: D000328:Adult; D000368:Aged; D000070642:Brain Injuries, Traumatic / Q000150:complications / Q000503:physiopathology*; D002560:Cerebrovascular Circulation; D005260:Female; D015600:Glasgow Coma Scale; D006706:Homeostasis; D006801:Humans; D007427:Intracranial Pressure; D008297:Male; D008875:Middle Aged
keywords: Cerebrovascular autoregulation monitoring; Optimal cerebral perfusion pressure; Outcome; Traumatic brain injury