TY  - JOUR
PY  - 2020//
TI  - Impact of a posttraumatic cerebral infarction on outcome in patients with TBI: the Italian multicenter cohort INCEPT study
JO  - Critical care : the Official Journal of the Critical Care Forum
A1  - Latronico, Nicola
A1  - Piva, Simone
A1  - Fagoni, Nazzareno
A1  - Pinelli, Lorenzo
A1  - Frigerio, Michele
A1  - Tintori, Davide
A1  - Berardino, Maurizio
A1  - Bottazzi, Andrea
A1  - Carnevale, Livio
A1  - Casalicchio, Tiziana
A1  - Castioni, Carlo Alberto
A1  - Cavallo, Simona
A1  - Cerasti, Davide
A1  - Citerio, Giuseppe
A1  - Fontanella, Marco
A1  - Galiberti, Serena
A1  - Girardini, Alan
A1  - Gritti, Paolo
A1  - Manara, Ornella
A1  - Maremmani, Paolo
A1  - Mazzani, Roberta
A1  - Natalini, Giuseppe
A1  - Patassini, Mirko
A1  - Perna, Maria Elena
A1  - Pesaresi, Ilaria
A1  - Radolovich, Danila Katia
A1  - Saini, Maurizio
A1  - Stefini, Roberto
A1  - Minelli, Cosetta
A1  - Gasparotti, Roberto
A1  - Rasulo, Francesco A.
SP  - e33
EP  - e33
VL  - 24
IS  - 1
N2  - BACKGROUND: Post-traumatic cerebral infarction (PTCI) is common after traumatic brain injury (TBI). It is unclear what the occurrence of a PTCI is, how it impacts the long-term outcome, and whether it adds incremental prognostic value to established outcome predictors. <br><br>METHODS: This was a prospective multicenter cohort study of moderate and severe TBI patients. The primary objective was to evaluate if PTCI was an independent risk factor for the 6-month outcome assessed with the Glasgow Outcome Scale (GOS). We also assessed the PTCI occurrence and if it adds incremental value to the International Mission for Prognosis and Clinical Trial design in TBI (IMPACT) core and extended models. <br><br>RESULTS: We enrolled 143 patients, of whom 47 (32.9%) developed a PTCI. In the multiple ordered logistic regression, PTCI was retained in both the core and extended IMPACT models as an independent predictor of the GOS. The predictive performances increased significantly when PTCI was added to the IMPACT core model (AUC = 0.73, 95% C.I. 0.66-0.82; increased to AUC = 0.79, 95% CI 0.71-0.83, p = 0.0007) and extended model (AUC = 0.74, 95% C.I. 0.65-0.81 increased to AUC = 0.80, 95% C.I. 0.69-0.85; p = 0.00008). Patients with PTCI showed higher ICU mortality and 6-month mortality, whereas hospital mortality did not differ between the two groups. <br><br>CONCLUSIONS: PTCI is a common complication in patients suffering from a moderate or severe TBI and is an independent risk factor for long-term disability. The addition of PTCI to the IMPACT core and extended predictive models significantly increased their performance in predicting the GOS. TRIAL REGISTRATION: The present study was registered in ClinicalTrial.gov with the ID number NCT02430324.<p />  <p>Language: en</p>
LA  - en
SN  - 1364-8535
UR  - http://dx.doi.org/10.1186/s13054-020-2746-5
ID  - ref1
ER  -