Comparisons of Acute Physiological Parameters Influencing Outcome in Patients with Traumatic Brain Injury and Hemorrhagic Stroke

Abstract

Although several factors are known to influence prognosis after acute brain injury, physiologic derangements were found to be associated with, or contributing to, increased mortality and disability in these patients. This study was conducted to identify acute physiological parameters that significantly predict outcome and compare the identified parameters in patients with traumatic brain injury (TBI) and hemorrhagic stroke. Participants were 190 adult patients with TBI or hemorrhagic stroke who were admitted within 24 hours of injury. Details concerning potential physiological predictors were collected, that is, blood pressure (BP), heart rate, respiratory rate, body temperature, hematocrit, partial pressure of oxygen and carbon dioxide in arterial blood, serum osmolality, pH, total cholesterol, and glucose levels on admission. Mortality and functional and cognitive ability 6 months after injury were measured as outcome variables. Most physiological parameters, with the exceptions of blood glucose, total cholesterol, and osmolality, were significant prognostic predictors in TBI and hemorrhagic stroke. However, the physiological parameters and their predictabilities differed in patients with TBI and hemorrhagic stroke, which indicated that physiological predictors depend on chosen outcome and brain injury type. In critical care units, the most important aims of nursing care are decreasing mortality and disability rates. In order to achieve such goals, acute physiological parameters such as BP, respiratory rate, heart rate, PaO2, PaCO2, and temperature should be monitored and managed, with the aim of reducing the risk of secondary brain injury.