Prehospital hypoxia affects outcome in patients with traumatic brain injury: a prospective multicenter study.

Prehospital hypoxia affects outcome in patients with traumatic brain injury: a prospective multicenter study. Research Abstract Details 

Research Abstract Table of Contents

Jump to the:

Prehospital hypoxia affects outcome in patients with traumatic brain injury: a prospective multicenter study. Abstract Text:

John H Chi,M Margaret Knudson,Mary J Vassar,Mary C McCarthy,Michael B Shapiro,Susan Mallet,John J Holcroft,Hugh Moncrief,Jennifer Noble,David Wisner,Krista L Kaups,Lynn D Bennick,Geoffrey T Manley,

BACKGROUND: The goals of this study were to determine the incidence and duration of hypotension and hypoxia in the prehospital setting in patients with potentially survivable brain injuries, and to prospectively examine the association of these secondary insults with mortality and disability at hospital discharge. METHODS: Trauma patients with suspected brain injuries underwent continuous blood pressure and pulse oximetry monitoring during helicopter transport. Postadmission inclusion criteria were (1) diagnosis of acute traumatic brain injury (TBI) confirmed by computed tomography (CT) scan, operative findings, or autopsy findings; and (2) Head Abbreviated Injury Scale (AIS) score of > or = 3 or Glasgow Coma Scale (GCS) score of < or = 12 within the first 24 hours of admission. Patients were excluded with (1) no abnormal intracranial findings on the patient's CT scan; (2) determination of a nonsurvivable injury (based on an AIS score of 6 for any body region; or, (3) death in less than 12 hours after injury. Primary outcome measures included mortality and Disability Rating Scale score at discharge. RESULTS: We enrolled 150 patients into the study. Fifty-seven patients had at least one secondary insult; 37 had only hypoxic episodes, 14 had only hypotensive episodes, and 6 patients had both. Demographics and injury characteristics did not differ between those with and those without secondary insults. The mortality for patients without secondary insults was 20%, compared with 37% for patients with hypoxic episodes, 8% for patients with hypotensive episodes, and 24% for patients with both. The Disability Rating Scale score at discharge was significantly higher in patients with secondary insults. Using multivariate analysis, the calculated odds ratio of mortality caused by prehospital hypoxia after head injury was 2.66 (p < 0.05). CONCLUSIONS: Secondary insults after TBI are common, and these insults are associated with disability. Hypoxia in the prehospital setting significantly increases the odds of mortality after brain injury controlled for multiple variables.

Prehospital hypoxia affects outcome in patients with traumatic brain injury: a prospective multicenter study. Publishing Authors By Initials

JH Chi,MM Knudson,MJ Vassar,MC McCarthy,MB Shapiro,S Mallet,JJ Holcroft,H Moncrief,J Noble,D Wisner,KL Kaups,LD Bennick,GT Manley,

For similar disorders of environmental origin: wounds and injuries: wounds, nonpenetrating research abstracts see: disorders of environmental origin: wounds and injuries: wounds, nonpenetrating research

PUBMED ID PMID:

MEDLINE DATE:

Prehospital hypoxia affects outcome in patients with traumatic brain injury: a prospective multicenter study. Journal Published:

PUBLICATION TYPE: Research Support, U.S. Gov't,

Journal: The Journal of trauma

VOLUME: 61

Page Numbers: 1134-41

Journal Abbreviation:

ISSN: 0022-5282

DAY: 3

MONTH: Nov

YEAR: 2006

Prehospital hypoxia affects outcome in patients with traumatic brain injury: a prospective multicenter study. Information

Number of References:

LANGUAGE: eng

NlmUniqueID: 376373

Prehospital hypoxia affects outcome in patients with traumatic brain injury: a prospective multicenter study. Keywords Mesh Terms:

KEYWORDS: Wounds, Nonpenetrating

MESH TERMS: mortality

Chemical & Substance for Abstract: Prehospital hypoxia affects outcome in patients with traumatic brain injury: a prospective multicenter study. Information

Substance Name:

Registry Number:

Grant and Affiliation Information for Prehospital hypoxia affects outcome in patients with traumatic brain injury: a prospective multicenter study.

AFFILIATION: Department of Surgery, the University of California, San Francisco and the San Francisco Injury Center for Research and Prevention, San Francisco, California 94143, USA. chijo@neurosurg.ucsf.edu

Country: United States

AGENCY: United States PHS

GRANT: R49/CCR903697

ACRONYM:

MEDLINETA: J Trauma

REFSOURCE:

DATABASENAME:

ACCESSION NUMBER:

Number Hits: 0

Prehospital hypoxia affects outcome in patients with traumatic brain injury: a prospective multicenter study Related Publications

• A complex signaling pathway regulates SRp38 phosphorylation and pre-mrna splicing in response to heat shock.
• A ported, proximally-cemented femoral stem for total hip arthroplasty. Development and clinical application.
• Aquaporins: role in cerebral edema and brain water balance.
• Atypical memory phenotype T cells with low homeostatic potential and impaired TCR signaling and regulatory T cell function in Foxn1Delta/Delta mutant mice.
• Concurrent splicing and transcription are not sufficient to enhance splicing efficiency.
• Diabetes mellitus in childhood; report of a local survey.
• Dose-response relationship of mannitol and intracranial pressure: a metaanalysis.
• Estimated average glucose derived from HbA(1c) (eAG): report from European Association for the Study of Diabetes (EASD), Amsterdam 2007.
• Gcm2 is required for the differentiation and survival of parathyroid precursor cells in the parathyroid/thymus primordia.
• Human capping enzyme promotes formation of transcriptional R loops in vitro.
• New approaches to physiological informatics in neurocritical care.
• New insights into mitotic chromosome condensation: a role for the prolyl isomerase pin1.
• Pin1 modulates RNA polymerase II activity during the transcription cycle.
• Prehospital hypoxia affects outcome in patients with traumatic brain injury: a prospective multicenter study.
• Protein-free spliceosomal snRNAs catalyze a reaction that resembles the first step of splicing.
• Relationship between brain tissue oxygen tension and CT perfusion: feasibility and initial results.
• Specific expression of lacZ and cre recombinase in fetal thymic epithelial cells by multiplex gene targeting at the Foxn1 locus.
• Sumoylation modulates the assembly and activity of the pre-mRNA 3' processing complex.
• Sumoylation regulates multiple aspects of mammalian poly(A) polymerase function.
• T cell development from kit-negative progenitors in the foxn1{delta}/{delta} mutant thymus.
• The RNA binding protein RNPS1 alleviates ASF/SF2 depletion-induced genomic instability.
• The impact of smoking-cessation intervention by multiple health professionals.
• The isolation and characterization of glycosaminoglycans in normal human serum.
• The multifunctional protein p54nrb/PSF recruits the exonuclease XRN2 to facilitate pre-mRNA 3' processing and transcription termination.
• The prolyl isomerase Pin1 functions in mitotic chromosome condensation.
• The role of lung function in brain tissue oxygenation following traumatic brain injury.
• The search for alternative splicing regulators: new approaches offer a path to a splicing code.
• Vancomycin use in patients requiring hemodialysis: a literature review.
• Variations in intracellular levels of TATA binding protein can affect specific genes by different mechanisms.
• hnRNP A1 functions with specificity in repression of SMN2 exon 7 splicing.