Research Reports - Complexity of intracranial pressure correlates with outcome after traumatic brain injury

Brain. 2012 Jun 25

Lu CW, Czosnyka M, Shieh JS, Smielewska A, Pickard JD, Smielewski P

This study applied multiscale entropy analysis to investigate the correlation
between the complexity of intracranial pressure waveform and outcome after
traumatic brain injury. Intracranial pressure and arterial blood pressure
waveforms were low-pass filtered to remove the respiratory and pulse components
and then processed using a multiscale entropy algorithm to produce a complexity
index. We identified significant differences across groups classified by the
Glasgow Outcome Scale in intracranial pressure, pressure-reactivity index and
complexity index of intracranial pressure (P < 0.0001; P = 0.001; P < 0.0001,
respectively). Outcome was dichotomized as survival/death and also as
favourable/unfavourable. The complexity index of intracranial pressure achieved
the strongest statistical significance (F = 28.7; P < 0.0001 and F = 17.21;
P < 0.0001, respectively) and was identified as a significant independent
predictor of mortality and favourable outcome in a multivariable logistic
regression model (P < 0.0001). The results of this study suggest that complexity
of intracranial pressure assessed by multiscale entropy was significantly
associated with outcome in patients with brain injury.
 

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