TY  - JOUR
PY  - 2022//
TI  - Circadian rhythmicity of vital signs at intensive care unit discharge and outcome of traumatic brain injury
JO  - American journal of critical care: an official publication, American Association of Critical-Care Nurses
A1  - Boots, Rob
A1  - Xue, George
A1  - Tromp, Dirk
A1  - Rawashdeh, Oliver
A1  - Bellapart, Judith
A1  - Townsend, Shane
A1  - Rudd, Michael
A1  - Winter, Craig
A1  - Mitchell, Gary
A1  - Garner, Nicholas
A1  - Clement, Pierre
A1  - Karamujic, Nermin
A1  - Zappala, Christopher
SP  - 472
EP  - 482
VL  - 31
IS  - 6
N2  - BACKGROUND: Physiological functions with circadian rhythmicity are often disrupted during illness. <br><br>OBJECTIVE: To assess the utility of circadian rhythmicity of vital signs in predicting outcome of traumatic brain injury (TBI). <br><br>METHODS: A retrospective single-center cohort study of adult intensive care unit (ICU) patients with largely isolated TBI to explore the relationship between the circadian rhythmicity of vital signs during the last 24 hours before ICU discharge and clinical markers of TBI severity and score on the Glasgow Outcome Scale 6 months after injury (GOS-6). <br><br>RESULTS: The 130 study participants had a median age of 39.0 years (IQR, 23.0-59.0 years), a median Glasgow Coma Scale score at the scene of 8.0 (IQR, 3.0-13.0), and a median Rotterdam score on computed tomography of the head of 3 (IQR, 3-3), with 105 patients (80.8%) surviving to hospital discharge. Rhythmicity was present for heart rate (30.8% of patients), systolic blood pressure (26.2%), diastolic blood pressure (20.0%), and body temperature (26.9%). Independent predictors of a dichotomized GOS-6 ≥4 were the Rotterdam score (odds ratio [OR], 0.38 [95% CI, 0.18-0.81]; P =.01), Glasgow Coma Scale score at the scene (OR, 1.22 [95% CI, 1.05-1.41]; P =.008), age (OR, 0.95 [95% CI, 0.92-0.98]; P =.003), oxygen saturation <90% in the first 24 hours (OR, 0.19 [95% CI, 0.05-0.73]; P =.02), serum sodium level <130 mmol/L (OR, 0.20 [95% CI, 0.05-0.70]; P =.01), and active intracranial pressure management (OR, 0.16 [95% CI, 0.04-0.62]; P =.008), but not rhythmicity of any vital sign. <br><br>CONCLUSION: Circadian rhythmicity of vital signs at ICU discharge is not predictive of GOS-6 in patients with TBI.<p />  <p>Language: en</p>
LA  - en
SN  - 1062-3264
UR  - http://dx.doi.org/10.4037/ajcc2022821
ID  - ref1
ER  -