Relationship between the bedside transcranial Doppler ultrasound pulse index and intracranial pressure and prognosis in patients with neurocritical disease

LI Mengdi; LOU Junge; ZHANG Xiaoyan; YAN Yuanyuan

doi:10.20258/j.cnki.1006-9011.2025.02.003

Abstract：Objective To analyze the relationship between the bedside transcranial doppler ultrasound(TCD)pulse index(PI)and intracranial pressure(ICP)and prognosis of patients with neurocritical disease.Methods A total of 184 patients with severe neurological diseases admitted were selected as the study objects.TCD examination was performed to obtain PI levels.ICP levels were measured by bedside lumbar puncture.Pearson correlation analysis was used to analyze the correlation between PI values and ICP values.Patients were divided into death group and survival group according to whether death occurred during hos-pitalization.The clinical data,PI and ICP of the death group and the survival group were compared,and the risk factors affecting the death of patients with neurocritical conditions were analyzed by multi-factor analysis,and the predictive value of PI in the death of patients with neurocritical conditions was analyzed by drawing receiver operating characteristic(ROC)curve.Results PI and ICP levels of patients were(1.37±0.26)and(20.77±3.18)mmHg,respectively.Person correlation analysis showed that PI level of patients with critical neurological conditions was positively correlated with ICP(r=0.549,P<0.05).The level of ICU stay,PI and ICP in death group was higher than that in survival group(P<0.05),and the level of Glasgow Coma Score(GCS)was lower than that in survival group(P<0.05).Logistic regression analysis showed that the length of hospital stay in ICU,abnormal levels of PI,ICP and GCS were risk factors for death in neurocritical ill patients(P<0.05).ROC curve results showed that the AUC,sensitivity,specificity,and optimal cut-off values of PI in predicting death in critically ill patients were 0.833(95%CI:0.741-0.925),87.90%,and 78.10%,respectively.Conclusion TCD-PI is positively correlated with ICP in patients with neurocritical ill,and is a risk factor for death in patients with this disorder.PI has a high predictive value for death in patients with neurocritical ill.