Incidence of Paroxysmal Sympathetic Hyperactivity after Traumatic Brain Injury in a Tertiary Care ICU: A Retrospective Cohort Study
Background Paroxysmal sympathetic hyperactivity (PSH) is an understudied complication of traumatic brain injury (TBI). PSH usually presents with transient rise in sympathetic outflow, leading to increased blood pressure, heart rate, temperature, respiratory rate, sweating, and posturing activity. We...
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| Format: | Article |
| Language: | English |
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Thieme Medical and Scientific Publishers Pvt. Ltd.
2021-04-01
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| Series: | Journal of Neuroanaesthesiology and Critical Care |
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| Online Access: | http://www.thieme-connect.de/DOI/DOI?10.1055/s-0040-1721553 |
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| author | Ajit Bhardwaj Ganesh C. Satapathy Arpit Garg Vikas Chawla Kiran Jangra |
| author_facet | Ajit Bhardwaj Ganesh C. Satapathy Arpit Garg Vikas Chawla Kiran Jangra |
| author_sort | Ajit Bhardwaj |
| collection | DOAJ |
| description | Background Paroxysmal sympathetic hyperactivity (PSH) is an understudied complication of traumatic brain injury (TBI). PSH usually presents with transient rise in sympathetic outflow, leading to increased blood pressure, heart rate, temperature, respiratory rate, sweating, and posturing activity. We retrospectively analyzed the incidence of PSH in TBI using PSH-assessment measure (PSH-AM) scale.
Methods This single-center retrospective cohort study was conducted in traumatic head injury patients admitted in the intensive care unit from January 1, 2016 to December 31, 2019 in a tertiary care center. The data was collected from the hospital database after obtaining approval from the hospital ethics committee.
Results A total of 287 patients (18–65 years of age) were admitted to intensive care unit (ICU) with TBI out of which 227 patients were analyzed who had ICU stay for more than 14 days. PSH was diagnosed in 70 (30.8%) patients. Mean age of PSH positive patients was 40 ± 18 and 49 ± 11 years for PSH negative patients (p < 0.001). The age group between 40 and 50 years had a higher incidence of PSH. The age and Glasgow coma score (GCS) were significantly associated with the occurrence of PSH. The GCS score demonstrated good accuracy for predicting the occurrence of PSH with AUC 0.83, 95% CI of 0.775 to 0.886, and a p-value of 0.001.
Conclusion We observed that the incidence of PSH was 30.8% in the patients with TBI. Age and GCS were found to have a significant association for predicting the occurrence of PSH. The patients who developed PSH had a longer length of hospital stay in ICU. |
| first_indexed | 2024-12-14T23:33:27Z |
| format | Article |
| id | doaj.art-17a0170391ee40858a7b6bf9faf40049 |
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| issn | 2348-0548 2348-926X |
| language | English |
| last_indexed | 2024-12-14T23:33:27Z |
| publishDate | 2021-04-01 |
| publisher | Thieme Medical and Scientific Publishers Pvt. Ltd. |
| record_format | Article |
| series | Journal of Neuroanaesthesiology and Critical Care |
| spelling | doaj.art-17a0170391ee40858a7b6bf9faf400492022-12-21T22:43:40ZengThieme Medical and Scientific Publishers Pvt. Ltd.Journal of Neuroanaesthesiology and Critical Care2348-05482348-926X2021-04-01080318719110.1055/s-0040-1721553Incidence of Paroxysmal Sympathetic Hyperactivity after Traumatic Brain Injury in a Tertiary Care ICU: A Retrospective Cohort StudyAjit Bhardwaj0Ganesh C. Satapathy1Arpit Garg2Vikas Chawla3Kiran Jangra4Department of Anaesthesia, Critical Care Command Hospital, Lucknow, Uttar Pradesh, IndiaDepartment of Anaesthesia, Critical Care Command Hospital, Lucknow, Uttar Pradesh, IndiaDepartment of Anaesthesia, Critical Care Command Hospital, Lucknow, Uttar Pradesh, IndiaDepartment of Anaesthesia, Critical Care Command Hospital, Lucknow, Uttar Pradesh, IndiaDepartment of Anesthesia and Intensive Care, Post Graduate Institute of Medical Education and Research, Chandigarh, IndiaBackground Paroxysmal sympathetic hyperactivity (PSH) is an understudied complication of traumatic brain injury (TBI). PSH usually presents with transient rise in sympathetic outflow, leading to increased blood pressure, heart rate, temperature, respiratory rate, sweating, and posturing activity. We retrospectively analyzed the incidence of PSH in TBI using PSH-assessment measure (PSH-AM) scale. Methods This single-center retrospective cohort study was conducted in traumatic head injury patients admitted in the intensive care unit from January 1, 2016 to December 31, 2019 in a tertiary care center. The data was collected from the hospital database after obtaining approval from the hospital ethics committee. Results A total of 287 patients (18–65 years of age) were admitted to intensive care unit (ICU) with TBI out of which 227 patients were analyzed who had ICU stay for more than 14 days. PSH was diagnosed in 70 (30.8%) patients. Mean age of PSH positive patients was 40 ± 18 and 49 ± 11 years for PSH negative patients (p < 0.001). The age group between 40 and 50 years had a higher incidence of PSH. The age and Glasgow coma score (GCS) were significantly associated with the occurrence of PSH. The GCS score demonstrated good accuracy for predicting the occurrence of PSH with AUC 0.83, 95% CI of 0.775 to 0.886, and a p-value of 0.001. Conclusion We observed that the incidence of PSH was 30.8% in the patients with TBI. Age and GCS were found to have a significant association for predicting the occurrence of PSH. The patients who developed PSH had a longer length of hospital stay in ICU.http://www.thieme-connect.de/DOI/DOI?10.1055/s-0040-1721553dysautonomiafrontal lobe contusiontraumatic brain injuryglasgow coma scale |
| spellingShingle | Ajit Bhardwaj Ganesh C. Satapathy Arpit Garg Vikas Chawla Kiran Jangra Incidence of Paroxysmal Sympathetic Hyperactivity after Traumatic Brain Injury in a Tertiary Care ICU: A Retrospective Cohort Study Journal of Neuroanaesthesiology and Critical Care dysautonomia frontal lobe contusion traumatic brain injury glasgow coma scale |
| title | Incidence of Paroxysmal Sympathetic Hyperactivity after Traumatic Brain Injury in a Tertiary Care ICU: A Retrospective Cohort Study |
| title_full | Incidence of Paroxysmal Sympathetic Hyperactivity after Traumatic Brain Injury in a Tertiary Care ICU: A Retrospective Cohort Study |
| title_fullStr | Incidence of Paroxysmal Sympathetic Hyperactivity after Traumatic Brain Injury in a Tertiary Care ICU: A Retrospective Cohort Study |
| title_full_unstemmed | Incidence of Paroxysmal Sympathetic Hyperactivity after Traumatic Brain Injury in a Tertiary Care ICU: A Retrospective Cohort Study |
| title_short | Incidence of Paroxysmal Sympathetic Hyperactivity after Traumatic Brain Injury in a Tertiary Care ICU: A Retrospective Cohort Study |
| title_sort | incidence of paroxysmal sympathetic hyperactivity after traumatic brain injury in a tertiary care icu a retrospective cohort study |
| topic | dysautonomia frontal lobe contusion traumatic brain injury glasgow coma scale |
| url | http://www.thieme-connect.de/DOI/DOI?10.1055/s-0040-1721553 |
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