Journal
BRAIN
Volume 135, Issue -, Pages 2399-2408Publisher
OXFORD UNIV PRESS
DOI: 10.1093/brain/aws155
Keywords
complexity; intracranial pressure; multiscale entropy; traumatic brain injury; outcome
Categories
Funding
- National Institute of Health Research, Biomedical Research Centre (Neuroscience Theme)
- Medical Research Council [G0600986, G9439390]
- NIHR
- Center for Dynamical Biomarkers and Translational Medicine
- National Science Council [NSC 100-2911-I-008-001]
- MRC [G9439390, G0001237, G0600986] Funding Source: UKRI
- Medical Research Council [G0600986, G0001354, G1000183B, G0001237, G0001354B, G9439390] Funding Source: researchfish
- National Institute for Health Research [NF-SI-0508-10327] Funding Source: researchfish
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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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