From: Early neurological wake-up test in intubated patients with traumatic brain injury
Variables | Before propensity score matching | After propensity score matching | ||||||
---|---|---|---|---|---|---|---|---|
Patients without ENWT (n = 373) | Patients with ENWT (n = 1013) | P | SMD | Patients without ENWT (n = 352) | Patients with ENWT (n = 352) | P | SMD | |
Age (years), median (IQR) | 62.9 [49.8, 78.9] | 60.1 [41.2, 76.6] | 0.008 | 0.181 | 62.7 [48.8, 79.3] | 64.9 [49.5, 79.5] | 0.451 | 0.052 |
Sex | 0.21 | 0.079 | 0.319 | 0.081 | ||||
Female | 145 (38.9) | 355 (35) | 215 (61.1) | 201 (57.1) | ||||
Male | 228 (61.1) | 658 (65.0) | 137 (38.9) | 151 (42.9) | ||||
First care unit, n (%) | < 0.001 | 0.492 | 0.904 | 0.057 | ||||
Medical ICU | 56 (15.0) | 75 (7.4) | 51 (14.5) | 48 (13.6) | ||||
Neurogical ICU | 115 (30.8) | 184 (18.2) | 100 (28.4) | 107 (30.4) | ||||
Surgical ICU | 202 (54.2) | 754 (74.4) | 201 (57.1) | 197 (56.0) | ||||
Traumatic brain injury, n (%) | 0.001 | 0.291 | 0.448 | 0.198 | ||||
Laceration and contusion | 20 (5.3) | 87 (8.6) | 81 (23.0) | 71 (20.2) | ||||
Compression of brain | 88 (23.5) | 143 (14.1) | 10 (2.8) | 8 (2.3) | ||||
Concussion | 12 (3.2) | 26 (2.6) | 22 (6.2) | 31 (8.8) | ||||
Subarachnoid hemorrhage | 59 (15.7) | 174 (17.2) | 50 (14.2) | 62 (17.6) | ||||
Mixed subarachnoid, subdural, and extradural hemorrhage | 54 (14.4) | 170 (16.8) | 54 (15.3) | 44 (12.5) | ||||
Subdural hemorrhage | 87 (23.2) | 237 (23.4) | 86 (24.4) | 89 (25.3) | ||||
Unspecified intracranial hemorrhage | 31 (8.3) | 75 (7.4) | 33 (9.4) | 25 (7.1) | ||||
Unspecified intracranial injury | 24 (6.4) | 99 (9.8) | 16 (4.5) | 22 (6.2) | ||||
Richmond Agitation-Sedation Scale | -1 [-4, 1] | 0 [-4, 1] | 0.044 | 0.056 | 0 [-4, 1] | -1 [-4, 1] | 0.845 | 0.135 |
Prehospital GCS, median (IQR) | 9 [6, 12] | 10 [7, 12] | 0.397 | 0.112 | 8 [5, 10] | 8 [6, 11] | 0.759 | 0.038 |
Neurological severity | 0.066 | 0.114 | 0.397 | 0.072 | ||||
Mild/or moderate TBI | 65 (17.4) | 134 (13.2) | 57 (16.2) | 48 (13.6) | ||||
Severe TBI, n (%) | 308 (82.6) | 879 (86.8) | 295 (83.8) | 304 (86.4) | ||||
Admission location | < 0.001 | 0.217 | 0.816 | 0.023 | ||||
Emergency room | 225 (60.3) | 715 (70.6) | 218 (61.9) | 214 (60.8) | ||||
Others | 148 (39.7) | 298 (29.4) | 134 (38.1) | 138 (39.2) | ||||
Charlson Comorbidity Index, median (IQR) | 4.0 [1.0, 5.0] | 3.0 [0.0, 5.0] | 0.001 | 0.175 | 4.0 [1.0, 5.0] | 4.0 [1.0, 6.0] | 0.551 | 0.028 |
Severity of illness at admission | ||||||||
SOFA, median (IQR) | 5 [3, 8] | 4 [2, 6] | < 0.001 | 0.379 | 5 [3, 7] | 5.0 [3, 7] | 0.798 | 0.034 |
SAPS II, median (IQR) | 38 [30, 47] | 34 [27, 43] | < 0.001 | 0.304 | 38 [29, 46] | 37.0 [29, 46] | 0.98 | 0.001 |
APS III, median (IQR) | 43 [31, 62] | 37 [28, 50] | < 0.001 | 0.346 | 42 [30, 59] | 42.0 [30, 56] | 0.655 | 0.054 |
ICP monitoring on the first day, n (%) | 63 (16.9) | 100 (9.9) | < 0.001 | 0.472 | 63 (17.9) | 67 (19.0) | 0.699 | 0.016 |
Coexisting conditions | ||||||||
Coronary heart disease | 46 (12.3) | 87 (8.6) | 0.046 | 0.123 | 41 (11.6) | 42 (11.9) | 1 | 0.009 |
Congestive heart failure | 67 (18.0) | 123 (12.1) | 0.007 | 0.163 | 59 (16.8) | 50 (14.2) | 0.405 | 0.071 |
Cerebrovascular disease | 91 (24.4) | 204 (20.1) | 0.1 | 0.102 | 85 (24.1) | 77 (21.9) | 0.531 | 0.054 |
Chronic pulmonary disease | 49 (13.1) | 100 (9.9) | 0.1 | 0.102 | 45 (12.8) | 54 (15.3) | 0.386 | 0.074 |
Liver disease | 38 (10.2) | 54 (5.3) | 0.002 | 0.182 | 34 (9.7) | 21 (6.0) | 0.092 | 0.138 |
Diabetes mellitus | 73 (19.6) | 199 (19.6) | 1 | 0.002 | 64 (18.2) | 79 (22.4) | 0.19 | 0.106 |
Malignant cancer | 15 (4.0) | 43 (4.2) | 0.974 | 0.011 | 14 (4.0) | 15 (4.3) | 1 | 0.014 |
Rheumatic disease | 8 (2.1) | 15 (1.5) | 0.534 | 0.05 | 7 (2.0) | 8 (2.3) | 1 | 0.02 |
Sepsis | 238 (63.8) | 631 (62.3) | 0.649 | 0.031 | 220 (62.5) | 231 (65.6) | 0.432 | 0.065 |
Vital signs, median (IQR) | ||||||||
Heart rate (beats/min) | 84.9 [76.0, 98.6] | 83.6 [73.2, 95.4] | 0.052 | 0.136 | 85.1 [76.0, 98.6] | 82.2 [71.7, 95.2] | 0.011 | 0.212 |
Mean arterial pressure (mm Hg) | 79.1 [74.2, 86.2] | 80.3 [74.3, 87.0] | 0.296 | 0.074 | 80.0 [74.6, 86.7] | 78.1 [72.8, 84.6] | 0.016 | 0.161 |
Ventilatory frequency (breaths/min) | 19.0 [16.8, 21.5] | 18.2 [16.4, 20.5] | < 0.001 | 0.268 | 19.0 [16.8, 21.4] | 18.2 [16.5, 20.8] | 0.052 | 0.159 |
Body temperature (°C) | 37.0 [36.6, 37.4] | 37.2 [36.9, 37.6] | < 0.001 | 0.333 | 37.0 [36.6, 37.4] | 37.2 [36.8, 37.5] | 0.025 | 0.128 |
SpO2 (%) | 98.4 [97.0, 99.4] | 98.9 [97.9, 99.6] | < 0.001 | 0.35 | 98.4 [97.1, 99.4] | 98.8 [97.7, 99.6] | 0.001 | 0.253 |
Laboratory tests, median (IQR) | ||||||||
WBC count (k/uL) | 12.0 [8.9, 16.1] | 12.3 [9.6, 15.6] | 0.586 | 0.017 | 12.1 [9.1, 16.0] | 12.3 [9.5, 15.5] | 0.774 | 0.01 |
Platelet (k/uL) | 190.1 [139.2, 244.2] | 194.0 [148.0, 243.0] | 0.424 | 0.028 | 189.8 [140.7, 243.8] | 182.8 [136.0, 239.7] | 0.387 | 0.054 |
Glucose (mg/dL) | 139.0 [119.6, 167.1] | 133.2 [115.5, 153.3] | < 0.001 | 0.242 | 137.9 [119.1, 162.9] | 132.2 [115.2, 152.9] | 0.016 | 0.204 |
Hemoglobin (g/dL) | 11.2 [9.6, 12.7] | 11.5 [10.1, 12.9] | 0.022 | 0.145 | 11.3 [9.7, 12.7] | 11.2 [9.7, 12.5] | 0.635 | 0.025 |
Potassium (mmol/L) | 4.1 [3.7, 4.4] | 4.0 [3.7, 4.3] | 0.129 | 0.112 | 4.0 [3.7, 4.4] | 4.0 [3.8, 4.3] | 0.573 | 0.061 |
Sodium (mmol/L) | 140.5 [138.0, 143.0] | 140.0 [137.5, 142.0] | 0.003 | 0.2 | 140.6 [138.0, 143.0] | 140.0 [137.4, 142.0] | 0.004 | 0.224 |
Calcium (mmol/L) | 8.3 [7.8, 8.8] | 8.3 [7.8, 8.7] | 0.276 | 0.094 | 8.2 [7.8, 8.8] | 8.3 [7.8, 8.7] | 0.963 | 0.001 |
Chloride (mmol/L) | 106.0 [103.0, 109.5] | 106.0 [102.8, 109.0] | 0.631 | 0.067 | 106.0 [103.0, 109.8] | 106.0 [102.8, 109.3] | 0.582 | 0.093 |
Creatinine (mg/dL) | 0.9 [0.7, 1.2] | 0.9 [0.7, 1.1] | < 0.001 | 0.197 | 0.9 [0.7, 1.2] | 0.8 [0.7, 1.1] | 0.085 | 0.06 |
Blood urea nitrogen (mg/dL) | 16.8 [12.0, 22.4] | 15.0 [11.1, 21.0] | 0.004 | 0.179 | 16.5 [12.0, 22.0] | 15.7 [12.0, 23.0] | 0.952 | 0.023 |
International normalized ratio | 1.2 [1.1, 1.4] | 1.1 [1.1, 1.3] | 0.002 | 0.215 | 1.2 [1.1, 1.4] | 1.2 [1.1, 1.4] | 0.594 | 0.071 |
Partial thromboplastin time, s | 13.0 [12.0, 15.1] | 12.9 [11.8, 14.3] | 0.025 | 0.215 | 13.0 [11.9, 14.9] | 13.1 [12.0, 15.1] | 0.429 | 0.068 |
Alkaline phosphatase, U/L | 72.8 [55.0, 101.7] | 69.0 [54.0, 95.0] | 0.198 | 0.169 | 73.5 [56.0, 101.7] | 70.0 [55.6, 102.0] | 0.741 | 0.086 |
Aminotransferase aspartate, U/L | 54.0 [31.0, 147.9] | 48.2 [29.0, 112.9] | 0.035 | 0.196 | 54.0 [31.0, 149.4] | 53.5 [29.2, 123.5] | 0.314 | 0.184 |
Total bilirubin, mg/dL | 0.6 [0.4, 1.2] | 0.6 [0.4, 1.0] | 0.501 | 0.154 | 0.6 [0.4, 1.0] | 0.7 [0.4, 1.1] | 0.331 | 0.057 |
ENWT related complications | ||||||||
Hemodynamic instability, n (%) | 57 (15.3) | 61 (6.0) | < 0.001 | 0.304 | 48 (13.6) | 34 (9.7) | 0.127 | 0.124 |
Elevated ICP, n (%) | 6 (1.6) | 17 (1.7) | 1 | 0.005 | 6 (1.7) | 6 (1.7) | 1 | < 0.001 |
Unstable ventilation status, n (%) | 36 (9.7) | 54 (5.3) | 0.006 | 0.165 | 29 (8.2) | 26 (7.4) | 0.779 | 0.032 |