A recent study has determined that cerebral blood flow measured six to 12 hours after a traumatic brain injury (TBI) can be used to gauge the 6-month outcome for a patient.
The research, “Outcome Prediction within Twelve Hours after Severe Traumatic Brain Injury by Quantitative Cerebral Blood Flow,” was published last month in the Journal of Neurotrauma. The study was performed by researchers at the University of New Mexico in Albuquerque, Baylor College of Medicine in Houston, and the AMC Emergency Medicine Group in Albany, N.Y.
According to an abstract of the study, researchers measured quantitative cortical mantle cerebral blood flow (CBF) by stable xenon computed tomography (CT) within the first 12 hours after severe 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 (Glasgow Coma Scale [GCS] score ≤8) TBI,” the online abstract said.
The percentages of total cortical mantle volume was determined for each of the CBF strata. These outcomes were assessed by using the Glasgow Outcome Scale (GOS) score at a patient’s discharge and one, three and six months after discharge.
Quantitative cortical mantle CBF differentiated GOS 1 and GOS 2 (dead or vegetative state) from GOS 3–5 (severely disabled to good recovery; p<0.001).
“Receiver operating characteristic (ROC) curve analysis for percent total normal plus hyperemic flow volume (TNHV) predicting GOS 3–5 outcome at six months for CBF measured 6 and 12 hours after injury showed ROC area under the curve (AUC) cut-scores of 0.92 and 0.77, respectively,” according to the abstract.
The study found that the percent of TNHV is an independent predictor of GOS 3–5,” with an odds ratio of 1.460 per 10 percentage point increase, as is initial GCS score (OR=1.090),” the abstract stated.
“These results suggest that quantitative mantle cerebral blood flow (CBF), measured within the first six and 12 hours after a traumatic brain injury (TBI) predicts the 6-month outcome for a patient, which can help guide patient care and identifying patients for randomized clinical trials,” the abstract said in summary. “A larger multicenter randomized clinical trial is indicated.”
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