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• W2547372912 abstract "BACKGROUND:Thermoregulation is an important response after brain injury. Thermoregulatory variability may reflect the level of entropy of this mechanism. The study aims at testing the hypothesis that higher temperature variability would be associated with poor outcome after brain injury.METHODS:Multi-Center cohort study of brain-injured patients (AIS, sICH, aSAH, and TBI) at 94 ICUs throughout the United States. Temperature variability (Tvar) was defined as Tmax-Tmin(°C) within 24 hours of ICU admission. Tvar was log-transformed to meet assumptions of normality and homoscedasticity of residual variance terms. Poor outcome was defined as severe disability or in-hospital mortality. To test our hypothesis, we determine the association between (Tvar) and poor outcome using Generalized Estimating Equations and adjusting for known predictors of poor outcome after brain injury.RESULTS:13,695 patients participated in the study, 21[percnt] AIS, 31[percnt] ICH, 17[percnt] SAH, and 30[percnt] TBI. Tvar-Log was higher in TBI (0.14°C±0.01) as compared to AIS (-0.09°C±0.01), sICH (0.04°C±0.01), and aSAH (0.06°C±0.02) (p<0.001, ANOVA).Poor outcome was lower in TBI (26[percnt]) compared to ICH (50[percnt]), SAH (36[percnt]), and AIS (33[percnt]) (p<.001 for trend). The proportion of poor outcome increased per quartile (Q) of Tvar: 1stQ=27[percnt], 2ndQ=(26[percnt]), 3rdQ=(36[percnt]), and 4th Q (57[percnt]) (p<0.0001 for trend).In multivariable analysis, adjusting for known predictors of poor outcome after brain injury (age, race, gender, blood pressure, DNR status, GCS, diagnosis, and organ dysfunctions), Tvar-Log was associated with poor outcome (OR, 1.34; 95[percnt]CI, 1.25-1.43, p<0.0001). This association was only significant in ICH (OR, 1.1; 95[percnt]CI, 1.01-1.21, p=0.03) and SAH (OR, 1.2; 95[percnt]CI, 1.1-1.3, p=0.002).CONCLUSIONS:Temperature variability can independently predict poor outcome after brain injury. There appears to be differences in this association depending upon type of brain injury. Determination of patients at higher risk of poor outcome could be determined by determination of higher temperature fluctuation in the ICU. Disclosure: Dr. Thavapalan has nothing to disclose. Dr. Rincon has nothing to disclose." @default.
• W2547372912 created "2016-11-11" @default.
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• W2547372912 date "2016-04-05" @default.
• W2547372912 modified "2023-09-26" @default.
• W2547372912 title "Thermoregulatory Variability Is an Independent Predictor of Death or Poor Outcome After Brain Injury: A Cohort Study (S46.002)" @default.
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