• WhaSook Seo and HyunSoo Oh.
• Department of Nursing, College of Medicine, Inha University, Incheon, Republic of Korea. wschang@inha.ac.kr
• Worldviews Evid Based Nurs. 2009 Jan 1; 6 (1): 36-43.

BackgroundAlthough 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.AimsThis 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.MethodsParticipants 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.ResultsMost 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.Conclusions And ImplicationsIn 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.

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