The Relationship Between Early Blood Pressure Variability And Short-term Prognosis In Severe Traumatic Brain Injury Patients

【Objective】:To study the correlation of early blood pressure variabilityand short-term prognosis in severe traumatic brain injury patients withoutprevious hypertension history.【Materials and Methods】：107patients with severe traumatic braininjury were analyzed retrospectively in our hospital from January2007toMarch2011. The mean blood pressure, blood pressure variability（standard deviation、coefficient of variability：standard deviation/mean）in those with comatose（Glasgow coma score3～8）during the first24hours after trauma were investigated in3days after operation andGlasgow outcome scale(GOS) were evaluated after6mouths. Accordingto the GOS, all the patients were divided into two groups, Group A, goodprognosis (GOS1～3)and Group B, poor prognosis (GOS4～5).【Results】:1.There were older ages、lower Glasgow coma score(GCS)and Acute physiological and chronic health evaluationⅡScale(APACHEⅡScale)、higher standard deviation（SD）of systolicblood pressure and diastolic blood pressure and higher coefficient ofvariability（CV） of systolic blood pressure within72hours in Group A than those in Group B (P<0.01).2.Logistic regression analysis revealedthat:1)lower APACHEⅡScale、type of traumatic brain injury and highercoefficient of variability（CV） of systolic blood pressure within72hourswere risk factors for prognosis in model one. The ROC Curve revealedthat the cut-off value for CV of Systolic blood pressure was0.1146;thecorrect index、sensitivity and specificity were69.3%、80.6%and88.7%.2) lower APACHEⅡScale、type of traumatic brain injury and higherstandard deviation（SD）of Systolic blood pressure within72hours wererisk factors for prognosis in model two. The ROC Curve revealed that thecut-off value for SD of Systolic blood pressure was14.1320;the correctindex、sensitivity and specificity were72.0%、83.3%and88.7%.【Conclusions】：1.The old age、low APACHEⅡScale、type of traumaticbrain injury and high systolic blood pressure variability are the riskfactors for prognosis in severe traumatic brain injury patients withoutprevious hypertension history, among which the variability of systolicblood pressure plays the most important role.2.The preliminary results,patients with coefficient of variability（CV） of systolic blood pressureover0.1146or standard deviation（SD）of Systolic blood pressure over14.1320within72hours would suffer from poorer prognosis.