Association between Traumatic Subarachnoid Hemorrhage and Acute Respiratory Failure in Moderate-to-Severe Traumatic Brain Injury Patients
Acute respiratory failure (ARF) with a high incidence among moderate-to-severe traumatic brain injury (M-STBI) patients plays a pivotal role in worsening neurological outcomes. Traumatic subarachnoid hemorrhage (tSAH) is highly prevalent in M-STBI, which is associated with significant adverse outcom...
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| Format: | Article |
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MDPI AG
2022-07-01
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| Series: | Journal of Clinical Medicine |
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| Online Access: | https://www.mdpi.com/2077-0383/11/14/3995 |
| _version_ | 1797406018144043008 |
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| author | Min Li Rui Wang Qi-Xing Fang Yi-Xuan He Ying-Wu Shi Shun-Nan Ge Rui-Na Ma Yan Qu |
| author_facet | Min Li Rui Wang Qi-Xing Fang Yi-Xuan He Ying-Wu Shi Shun-Nan Ge Rui-Na Ma Yan Qu |
| author_sort | Min Li |
| collection | DOAJ |
| description | Acute respiratory failure (ARF) with a high incidence among moderate-to-severe traumatic brain injury (M-STBI) patients plays a pivotal role in worsening neurological outcomes. Traumatic subarachnoid hemorrhage (tSAH) is highly prevalent in M-STBI, which is associated with significant adverse outcomes. In this retrospective cohort study, we aimed to explore the association between the severity of the tSAH and ARF in the M-STBI population. A total of 771 subjects were reviewed. Clinical and neuroimaging data of M-STBI patients were retrospectively collected, and ARF was ascertained retrospectively based on their electronic medical record. The degree of tSAH was classified according to Fisher’s criteria, and the grade of tSAH was dichotomized to a low Fisher grade (Fisher grade 1–2) and a high Fisher grade (Fisher grade 3–4). After exclusion procedures, the data of 695 M-STBI patients were analyzed. A total of 284 (30.8%) had a high Fisher grade on admission. The overall rate of ARF within 48 h upon admission was 34.4% (239/695); it was 29.5% (142/481) and 46.3% (99/214) for the low and high Fisher groups, respectively. In a full cohort, a high Fisher grade was associated with ARF after adjusting for age, gender, GCS, smoking history, comorbidities, multiple injuries, characteristics of TBI, and pulmonary factors (OR 1.78; 95% CI, 1.11–2.85, <i>p</i> = 0.016). This result remained robust in the comparisons after PSM (71/132, 42.8% vs. 53/132, 31.9%; OR, 1.59; 95% CI, 1.02–2.49, <i>p</i> = 0.042). A high Fisher SAH grade exposure on admission is associated with ARF in M-STBI patients. |
| first_indexed | 2024-03-09T03:18:39Z |
| format | Article |
| id | doaj.art-29bb526394a44b21a97721650882af23 |
| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-09T03:18:39Z |
| publishDate | 2022-07-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Clinical Medicine |
| spelling | doaj.art-29bb526394a44b21a97721650882af232023-12-03T15:12:41ZengMDPI AGJournal of Clinical Medicine2077-03832022-07-011114399510.3390/jcm11143995Association between Traumatic Subarachnoid Hemorrhage and Acute Respiratory Failure in Moderate-to-Severe Traumatic Brain Injury PatientsMin Li0Rui Wang1Qi-Xing Fang2Yi-Xuan He3Ying-Wu Shi4Shun-Nan Ge5Rui-Na Ma6Yan Qu7Neurocritical Care Unit, Department of Neurosurgery, The Second Affiliated Hospitals, Fourth Military Medical University, Xi’an 710038, ChinaDepartment of Medical Management, The Second Affiliated Hospitals, Fourth Military Medical University, Xi’an 710038, ChinaNeurocritical Care Unit, Department of Neurosurgery, The Second Affiliated Hospitals, Fourth Military Medical University, Xi’an 710038, ChinaNeurocritical Care Unit, Department of Neurosurgery, The Second Affiliated Hospitals, Fourth Military Medical University, Xi’an 710038, ChinaNeurocritical Care Unit, Department of Neurosurgery, The Second Affiliated Hospitals, Fourth Military Medical University, Xi’an 710038, ChinaNeurocritical Care Unit, Department of Neurosurgery, The Second Affiliated Hospitals, Fourth Military Medical University, Xi’an 710038, ChinaDepartment of Pulmonary and Critical Care Medicine, The Second Affiliated Hospitals, Fourth Military Medical University, Xi’an 710038, ChinaNeurocritical Care Unit, Department of Neurosurgery, The Second Affiliated Hospitals, Fourth Military Medical University, Xi’an 710038, ChinaAcute respiratory failure (ARF) with a high incidence among moderate-to-severe traumatic brain injury (M-STBI) patients plays a pivotal role in worsening neurological outcomes. Traumatic subarachnoid hemorrhage (tSAH) is highly prevalent in M-STBI, which is associated with significant adverse outcomes. In this retrospective cohort study, we aimed to explore the association between the severity of the tSAH and ARF in the M-STBI population. A total of 771 subjects were reviewed. Clinical and neuroimaging data of M-STBI patients were retrospectively collected, and ARF was ascertained retrospectively based on their electronic medical record. The degree of tSAH was classified according to Fisher’s criteria, and the grade of tSAH was dichotomized to a low Fisher grade (Fisher grade 1–2) and a high Fisher grade (Fisher grade 3–4). After exclusion procedures, the data of 695 M-STBI patients were analyzed. A total of 284 (30.8%) had a high Fisher grade on admission. The overall rate of ARF within 48 h upon admission was 34.4% (239/695); it was 29.5% (142/481) and 46.3% (99/214) for the low and high Fisher groups, respectively. In a full cohort, a high Fisher grade was associated with ARF after adjusting for age, gender, GCS, smoking history, comorbidities, multiple injuries, characteristics of TBI, and pulmonary factors (OR 1.78; 95% CI, 1.11–2.85, <i>p</i> = 0.016). This result remained robust in the comparisons after PSM (71/132, 42.8% vs. 53/132, 31.9%; OR, 1.59; 95% CI, 1.02–2.49, <i>p</i> = 0.042). A high Fisher SAH grade exposure on admission is associated with ARF in M-STBI patients.https://www.mdpi.com/2077-0383/11/14/3995traumatic brain injuryFisher gradesubarachnoid hemorrhageacute respiratory failure |
| spellingShingle | Min Li Rui Wang Qi-Xing Fang Yi-Xuan He Ying-Wu Shi Shun-Nan Ge Rui-Na Ma Yan Qu Association between Traumatic Subarachnoid Hemorrhage and Acute Respiratory Failure in Moderate-to-Severe Traumatic Brain Injury Patients Journal of Clinical Medicine traumatic brain injury Fisher grade subarachnoid hemorrhage acute respiratory failure |
| title | Association between Traumatic Subarachnoid Hemorrhage and Acute Respiratory Failure in Moderate-to-Severe Traumatic Brain Injury Patients |
| title_full | Association between Traumatic Subarachnoid Hemorrhage and Acute Respiratory Failure in Moderate-to-Severe Traumatic Brain Injury Patients |
| title_fullStr | Association between Traumatic Subarachnoid Hemorrhage and Acute Respiratory Failure in Moderate-to-Severe Traumatic Brain Injury Patients |
| title_full_unstemmed | Association between Traumatic Subarachnoid Hemorrhage and Acute Respiratory Failure in Moderate-to-Severe Traumatic Brain Injury Patients |
| title_short | Association between Traumatic Subarachnoid Hemorrhage and Acute Respiratory Failure in Moderate-to-Severe Traumatic Brain Injury Patients |
| title_sort | association between traumatic subarachnoid hemorrhage and acute respiratory failure in moderate to severe traumatic brain injury patients |
| topic | traumatic brain injury Fisher grade subarachnoid hemorrhage acute respiratory failure |
| url | https://www.mdpi.com/2077-0383/11/14/3995 |
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