Relationship between transcranial Doppler ultrasound parameters and neurological injury and prognosis in patients with severe traumatic brain injury
BATULUHU
LV Quanlan
AMUJIERTU
CAI Wei
WANG Sheng
Abstract：Objective To investigate the relationship between transcranial Doppler ultrasound(TCD)parameters and neurological injury in patients with severe traumatic brain injury(sTBI)and to construct a nomogram model for predicting poor prognosis.Methods The clinical data of 94 patients with sTBI were analyzed retrospectively.According to the survival status of the patients after a 28-day follow-up,they were divided into a good prognosis group(survival,68 cases)and a poor prognosis group(fatality,26 cases).The survival time of patients with poor prognosis was recorded.TCD parameters[systolic peak flow velocity(Vs),mean peak flow velocity(Vm),resistance index(RI),and pulsatility index(PI)]and neurological injury indicators[neuron-specific enolase(NSE),S100 calcium binding protein β(S100β),N-terminal pro-brain natriuretic peptide(NT-proBNP),and Glasgow Coma Scale(GCS)score]were statistically analyzed and compared between the two groups.Survival curves were plotted to analyze the survival status of sTBI patients.Bivariate Pearson correlation analysis was used to analyze the relationship between TCD parameters and neurological injury in sTBI patients.Cox regression analysis was used to analyze the relationship between TCD parameters and prognosis in sTBI patients and to construct a nomogram prediction model.Results After a 28-day follow-up,the prognosis of the patients during this period was recorded.Among them,26 patients had a poor prognosis,with a poor prognosis rate of 27.66%(26/94),and the average survival time was 14.00(10.00,18.00)days.At admission,the RI and PI levels in the poor prognosis group were higher than those in the good prognosis group,while the Vs and Vm were lower than those in the good prognosis group,with statistically significant differences(all P<0.05).At admission,the levels of NSE and S100β in the poor prognosis group were higher than those in the good prognosis group,while the NT-proBNP level and GCS score were lower than those in the good prognosis group(all P<0.05).In sTBI patients,the RI and PI levels were positively correlated with NSE and S100β(RI:r=0.256,0.229;PI:r=0.255,0.280;all P<0.05)and negatively correlated with NT-proBNP and GCS(RI:r=-0.210,-0.237;PI:r=-0.219,-0.271;all P<0.05).The Vs and Vm levels were negatively correlated with NSE and S100β(Vs:r=-0.316,-0.314;Vm:r=-0.314,-0.282;all P<0.05)and positively correlated with NT-proBNP and GCS(Vs:r=0.218,0.511;Vm:r=0.274,0.287;all P<0.05).Cox regression analysis showed that high levels of RI and PI were risk factors for poor prognosis in sTBI patients(HR=25.487,1.985;both P<0.05),while Vs and Vm were protective factors(HR=0.964,0.950;both P<0.05).The concordance index(C-index)of the nomogram model was 0.971.The area under the curve(AUC)for the model's prediction of poor prognosis in sTBI patients was 0.943,with a sensitivity of 0.846,a specificity of 0.941,and a Youden index of 0.787.Conclusions TCD parameters in sTBI patients are closely related to neurological injury.Meanwhile,a nomogram model constructed based on TCD parameters can effectively predict the risk of poor prognosis in patients.
Keywords：traumatic brain injuryseverenerve injurytranscranial Doppler ultrasoundprognosis
Publication Date：2026-02-20
Online Publishing Date：2026-03-18(First online date of this platform, not the publication date of the document)
Pages：6( 96-101 )