TY  - JOUR
PY  - 2021//
TI  - Incidence and clinical impact of myocardial injury following traumatic brain injury: a pilot TRACK-TBI study
JO  - Journal of Neurosurgical Anesthesiology
A1  - Krishnamoorthy, Vijay
A1  - Manley, Geoffrey T.
A1  - Jain, Sonia
A1  - Sun, Shelly
A1  - Foreman, Brandon
A1  - Komisarow, Jordan
A1  - Laskowitz, Daniel T.
A1  - Mathew, Joseph P.
A1  - Hernandez, Adrian
A1  - James, Michael L.
A1  - Vavilala, Monica S.
A1  - Markowitz, Amy J.
A1  - Korley, Frederick K.
SP  - ePub
EP  - ePub
VL  - ePub
IS  - ePub
N2  - BACKGROUND: Traumatic brain injury (TBI) is a major global health problem. Little research has addressed extracranial organ dysfunction following TBI, particularly myocardial injury. Using a sensitive marker of myocardial injury-high sensitivity troponin (hsTn)-we examined the incidence of early myocardial injury following TBI and explored its association with neurological outcomes following moderate-severe TBI. <br><br>METHODS: We conducted a pilot cohort study of 133 adult (age above 17 y) subjects enrolled in the TRACK-TBI 18-center prospective cohort study. Descriptive statistics were used to examine the incidence of myocardial injury (defined as hsTn >99th percentile for a standardized reference population) across TBI severities, and to explore the association of myocardial injury with a 6-month extended Glasgow Outcome Score among patients with moderate-severe TBI. <br><br>RESULTS: The mean (SD) age of the participants was 44 (17) years, and 87 (65%) were male. Twenty-six patients (20%) developed myocardial injury following TBI; myocardial injury was present in 15% of mild TBI patients and 29% of moderate-severe TBI patients (P=0.13). Median (interquartile range) hsTn values were 3.8 ng/L (2.1, 9.0), 5.8 ng/L (4.5, 34.6), and 10.2 ng/L (3.0, 34.0) in mild, moderate, and severe TBI participants, respectively (P=0.04). Overall, 11% of participants with moderate-severe TBI and myocardial injury experienced a good outcome (6-mo extended Glasgow Outcome Score≥5) at 6 months, compared with 65% in the group that did not experience myocardial injury (P=0.01). <br><br>CONCLUSIONS: Myocardial injury is common following TBI, with a likely dose-response relationship with TBI severity. Early myocardial injury was associated with poor 6-month clinical outcomes following moderate-severe TBI.<p />  <p>Language: en</p>
LA  - en
SN  - 0898-4921
UR  - http://dx.doi.org/10.1097/ANA.0000000000000772
ID  - ref1
ER  -