Risk factors and the prognosis of acute respiratory distress syndrome in the patients with severe traumatic brain injury
Zhao Yang
Yuan Xuefeng
Zhang Wei
Sun Zhaorui
Nie Shinan
Abstract：Objective To investigate the risk factors of acute respiratory distress syndrome(ARDS)after severe traumatic brain injury(sTBI)and to analyze the prognosis of patients.Methods A total of 328 patients with simple sTBI treated in the General Hospital of the Eastern Theater Command of Chinese People's Liberation Army from January 2018 to January 2024 were retrospectively included,and were divided into ARDS group(107 cases)and non-ARDS group(221 cases)according to whether ARDS occurred within 7 d after injury.General information of the patients(age,gender,smoking,diabetes,hypertension,etc.),the degree of trauma[head abbreviated injury scale(AIS),Glasgow coma scale(GCS),blood transfusion and platelet transfusion]and related blood biochemical indicators[including base excess(BE),serum creatinine(SCr),blood urea nitrogen,procalcitonin(PCT)]were used to evaluate the risk factors of ARDS in sTBI by univariate and multivariate method.A risk prediction model curve was drawn,and the prognostic analysis was performed.Results Almost all sTBI patients experienced ARDS within 7 d of injury,the age＞55,blood glucose levels,serum PCT levels,shock,platelet transfusion＞10 U,GCS score,serum BE＜-6 mmol/L,SCr levels and blood urea nitrogen levels showed statistical significance between two groups(P＜0.05).Multivariate Logistic regression analysis results showed that the age＞55,low GCS score(＜8 scores),shock,platelet infusion＞10 U and serum PCT level ≥ 10.01 µg/L were risk factors for ARDS after sTBI.The mortality rate(61.5％vs.26.4％),average length of hospital stay(d:14.8±3.4 vs.11.4±3.6),and duration of mechanical ventilation(d:11.6±2.8vs.7.8±2.1)in ARDS group were higher than those in the non-ARDS(P＜0.05).Conclusions Low GCS score(＜8 scores),age＞55,platelet infusion＞10 U,shock,and serum PCT levels ≥10.01 μg/L are independent risk factors for the occurrence of ARDS after sTBI.Early identification and timely joint intervention may reduce the incidence of complications in sTBI patients with high-risk factors.
Keywords：Traumatic brain injuryAcute respiratory distress syndromeRisk factorsPrognosisShockProcalcitonin
Publication Date：2024-09-10
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：5( 765-769 )