• Am J Emerg Med · Aug 2022

    The association between blood pressure and in-hospital mortality in traumatic brain injury: Evidence from a 10-year analysis in a single-center.

    • Huai-Kuan Huang, Chi-Yuan Liu, I-Shiang Tzeng, Tsung-Han Hsieh, Chun-Yu Chang, Yueh-Tseng Hou, Po-Chen Lin, Yu-Long Chen, Da-Sen Chien, Giou-Teng Yiang, and Meng-Yu Wu.
    • Department of Emergency Medicine, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei 231, Taiwan.; Department of Emergency Medicine, School of Medicine, Tzu Chi University, Hualien 970, Taiwan.
    • Am J Emerg Med. 2022 Aug 1; 58: 265-274.

    ObjectiveBlood pressure in patients with traumatic brain injury (TBI) is associated with clinical outcome. However, evidence of blood pressure (BP) range is scarce and the association between BP and clinical outcome is mostly controversial. We aimed to investigate the association between blood pressure and clinical outcome in TBI.MethodsThis is a retrospective cohort study using the Taipei Tzu Chi Hospital trauma database from January 2009 to June 2019; totally, 13,114 patients were examined. The primary outcome of this investigation was in-hospital mortality and the secondary outcomes were intensive care unit (ICU) admission rate and prolong ICU stay (defined as stay in ICU ≥ 14 days). Subgroups analysis of Glasgow Coma Scale (GCS) and Triage SBP was also conducted.ResultsA total of 1782 traumatic adult patients with TBI (AIS score < 3) were finally included. The cut-off points are 130 mmHg to 149 mmHg in all TBI patients with lower odds ratio of mortality. In different TBI severity, U-shape relationship also presented and we also found that cut-off points of 130 to 149 mmHg in mild TBI and 110 to 129 mmHg in moderate TBI have lower odds ratio of mortality. The mortality is significantly increased in BP below 90 mmHg and above 190 mmHg in TBI patients.ConclusionsTraumatic brain injury population presented a U-shape relationship between triage SBP and in-hospital mortality. Early resuscitation and correct hypotension/hypertension in TBI population with BP below 90 mmHg and above 190 mmHg may prevent from increased mortality.Copyright © 2022 Elsevier Inc. All rights reserved.

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