Incidence of Paroxysmal Sympathetic Hyperactivity after Traumatic Brain Injury in a Tertiary Care ICU: A Retrospective Cohort Study

Background Paroxysmal sympathetic hyperactivity (PSH) is an understudied complication of traumatic brain injury (TBI). PSH usually presents with transient rise in sympathetic outflow, leading to increased blood pressure, heart rate, temperature, respiratory rate, sweating, and posturing activity. We...

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Autores principales:	Ajit Bhardwaj, Ganesh C. Satapathy, Arpit Garg, Vikas Chawla, Kiran Jangra
Formato:	article
Lenguaje:	EN
Publicado:	Thieme Medical and Scientific Publishers Pvt. Ltd. 2021
Materias:	dysautonomia frontal lobe contusion traumatic brain injury glasgow coma scale Anesthesiology RD78.3-87.3
Acceso en línea:	https://doaj.org/article/17a0170391ee40858a7b6bf9faf40049
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spelling	oai:doaj.org-article:17a0170391ee40858a7b6bf9faf400492021-12-02T23:53:13ZIncidence of Paroxysmal Sympathetic Hyperactivity after Traumatic Brain Injury in a Tertiary Care ICU: A Retrospective Cohort Study2348-05482348-926X10.1055/s-0040-1721553https://doaj.org/article/17a0170391ee40858a7b6bf9faf400492021-04-01T00:00:00Zhttp://www.thieme-connect.de/DOI/DOI?10.1055/s-0040-1721553https://doaj.org/toc/2348-0548https://doaj.org/toc/2348-926XBackground Paroxysmal sympathetic hyperactivity (PSH) is an understudied complication of traumatic brain injury (TBI). PSH usually presents with transient rise in sympathetic outflow, leading to increased blood pressure, heart rate, temperature, respiratory rate, sweating, and posturing activity. We retrospectively analyzed the incidence of PSH in TBI using PSH-assessment measure (PSH-AM) scale. Methods This single-center retrospective cohort study was conducted in traumatic head injury patients admitted in the intensive care unit from January 1, 2016 to December 31, 2019 in a tertiary care center. The data was collected from the hospital database after obtaining approval from the hospital ethics committee. Results A total of 287 patients (18–65 years of age) were admitted to intensive care unit (ICU) with TBI out of which 227 patients were analyzed who had ICU stay for more than 14 days. PSH was diagnosed in 70 (30.8%) patients. Mean age of PSH positive patients was 40 ± 18 and 49 ± 11 years for PSH negative patients (p < 0.001). The age group between 40 and 50 years had a higher incidence of PSH. The age and Glasgow coma score (GCS) were significantly associated with the occurrence of PSH. The GCS score demonstrated good accuracy for predicting the occurrence of PSH with AUC 0.83, 95% CI of 0.775 to 0.886, and a p-value of 0.001. Conclusion We observed that the incidence of PSH was 30.8% in the patients with TBI. Age and GCS were found to have a significant association for predicting the occurrence of PSH. The patients who developed PSH had a longer length of hospital stay in ICU.Ajit BhardwajGanesh C. SatapathyArpit GargVikas ChawlaKiran JangraThieme Medical and Scientific Publishers Pvt. Ltd.articledysautonomiafrontal lobe contusiontraumatic brain injuryglasgow coma scaleAnesthesiologyRD78.3-87.3ENJournal of Neuroanaesthesiology and Critical Care, Vol 08, Iss 03, Pp 187-191 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	dysautonomia frontal lobe contusion traumatic brain injury glasgow coma scale Anesthesiology RD78.3-87.3
spellingShingle	dysautonomia frontal lobe contusion traumatic brain injury glasgow coma scale Anesthesiology RD78.3-87.3 Ajit Bhardwaj Ganesh C. Satapathy Arpit Garg Vikas Chawla Kiran Jangra Incidence of Paroxysmal Sympathetic Hyperactivity after Traumatic Brain Injury in a Tertiary Care ICU: A Retrospective Cohort Study
description	Background Paroxysmal sympathetic hyperactivity (PSH) is an understudied complication of traumatic brain injury (TBI). PSH usually presents with transient rise in sympathetic outflow, leading to increased blood pressure, heart rate, temperature, respiratory rate, sweating, and posturing activity. We retrospectively analyzed the incidence of PSH in TBI using PSH-assessment measure (PSH-AM) scale. Methods This single-center retrospective cohort study was conducted in traumatic head injury patients admitted in the intensive care unit from January 1, 2016 to December 31, 2019 in a tertiary care center. The data was collected from the hospital database after obtaining approval from the hospital ethics committee. Results A total of 287 patients (18–65 years of age) were admitted to intensive care unit (ICU) with TBI out of which 227 patients were analyzed who had ICU stay for more than 14 days. PSH was diagnosed in 70 (30.8%) patients. Mean age of PSH positive patients was 40 ± 18 and 49 ± 11 years for PSH negative patients (p < 0.001). The age group between 40 and 50 years had a higher incidence of PSH. The age and Glasgow coma score (GCS) were significantly associated with the occurrence of PSH. The GCS score demonstrated good accuracy for predicting the occurrence of PSH with AUC 0.83, 95% CI of 0.775 to 0.886, and a p-value of 0.001. Conclusion We observed that the incidence of PSH was 30.8% in the patients with TBI. Age and GCS were found to have a significant association for predicting the occurrence of PSH. The patients who developed PSH had a longer length of hospital stay in ICU.
format	article
author	Ajit Bhardwaj Ganesh C. Satapathy Arpit Garg Vikas Chawla Kiran Jangra
author_facet	Ajit Bhardwaj Ganesh C. Satapathy Arpit Garg Vikas Chawla Kiran Jangra
author_sort	Ajit Bhardwaj
title	Incidence of Paroxysmal Sympathetic Hyperactivity after Traumatic Brain Injury in a Tertiary Care ICU: A Retrospective Cohort Study
title_short	Incidence of Paroxysmal Sympathetic Hyperactivity after Traumatic Brain Injury in a Tertiary Care ICU: A Retrospective Cohort Study
title_full	Incidence of Paroxysmal Sympathetic Hyperactivity after Traumatic Brain Injury in a Tertiary Care ICU: A Retrospective Cohort Study
title_fullStr	Incidence of Paroxysmal Sympathetic Hyperactivity after Traumatic Brain Injury in a Tertiary Care ICU: A Retrospective Cohort Study
title_full_unstemmed	Incidence of Paroxysmal Sympathetic Hyperactivity after Traumatic Brain Injury in a Tertiary Care ICU: A Retrospective Cohort Study
title_sort	incidence of paroxysmal sympathetic hyperactivity after traumatic brain injury in a tertiary care icu: a retrospective cohort study
publisher	Thieme Medical and Scientific Publishers Pvt. Ltd.
publishDate	2021
url	https://doaj.org/article/17a0170391ee40858a7b6bf9faf40049
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Incidence of Paroxysmal Sympathetic Hyperactivity after Traumatic Brain Injury in a Tertiary Care ICU: A Retrospective Cohort Study

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