| OUTCOME PREDICTION WITHIN TWELVE HOURS AFTER SEVERE TRAUMATIC BRAIN INJURY BY QUANTITATIVE CEREBRAL BLOOD FLOW. | |
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MedLine Citation:
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PMID: 22111910 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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Abstract We measured quantitative cortical mantle cerebral blood flow (CBF) by stable xenon CT within the first 12 hours after severe traumatic brain injury (TBI) to determine whether neurologic outcome can be predicted by CBF stratification early after injury. Stable Xenon-CT was used for quantitative measurement of CBF (ml/100 g/min) in 22 cortical mantle regions stratified as follows: Low (0-8), Intermediate (9-30), Normal (31-70) and Hyperemic (>70) in 120 patients suffering severe (GCS < 8) traumatic brain injury (TBI). For each of these CBF strata, percentages of total cortical mantle volume were calculated. Outcomes were assessed by Glasgow Outcome Score (GOS) at discharge (DC), one, three and six months after discharge. Quantitative cortical mantle CBF differentiated GOS1 and GOS2 (dead or vegetative state) from GOS 3 to 5 (severely disabled to good recovery) P<0.001. Receiver Operating Characteristic (ROC) analysis for percent TNHV predicting GOS3-GOS5 outcome at six months for CBF measured <6 and <12 hrs after injury showed ROC area under the curve (AUC) cutscores of 0.92 and 0.77, respectively. In multivariate analysis, TNHV is an independent predictor of GOS3-GOS5 with an odds ratio of 1.460 per 10 percentage point increase, as is initial GCS (OR=1.090). The binary version of the Marshall CT score was an independent predictor at six months outcome whereas age was not. These results suggest that quantitative cerebral cortical CBF measured within the first six and 12 hours after TBI predicts six month outcome which may be useful in guiding patient care and identifying patients for randomized clinical trials. A larger multicenter randomized clinical trial is indicated. |
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Authors:
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Paul Kaloostian; Claudia Robertson; Shankar P Gopinath; Martina Stippler; C Christopher King; Clifford Qualls; Howard Yonas; Edwin M Nemoto |
Publication Detail:
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Type: JOURNAL ARTICLE Date: 2011-11-23 |
Journal Detail:
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Title: Journal of neurotrauma Volume: - ISSN: 1557-9042 ISO Abbreviation: - Publication Date: 2011 Nov |
Date Detail:
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Created Date: 2011-11-24 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 8811626 Medline TA: J Neurotrauma Country: - |
Other Details:
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Languages: ENG Pagination: - Citation Subset: - |
Affiliation:
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University of New Mexico, Neurosurgery, Albuquerque, New Mexico, United States; pkaloostian@salud.unm.edu. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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