Evaluation Of Bispectral Index In The Severity And Prognosis In Patients With Diffuse Axonal Injury

Objective:To investigate the effect of bispectral index(BIS)on the severity and prognosis in patients with diffuse axonal injury(DAI).Methods:1.There are totally 88 patients who were admitted in the First People's Hospital of Yancheng from January 2015 to January 2016 according to the clinical diagnostic criteria of DAI.Clinical data such as: gender,age,injuring reasons,pupil size,GCS and APACHE II score,and the outcome of DAI at 28 days post-injury.The BIS was continuously monitored for 12 h within the first 3 days or 24 hours after stoppage of sedative after admission to hospital.The mean value of BIS was evaluated.The levels of serum S100 protein and neuron specific enolase(NSE)at 6 h,12 h,1 d,3 d and 7 d post-injury were determined.2.The relationship between BISmean and GCS,APACHE II,and S100 protein and NSE were respectively analyzed.3.The patients were divided into 2 groups according to BIS: BIS<60 group(n=60)and BIS?60 group(n=28).Comparisons between two groups were performed using the t test or ?2 test.4.The patients were divided into 2 groups according to outcome: the survival group(n=48)and the death group(n=40).Comparisons between two groups were performed using the t test or ?2 test.Differences between the groups were assessed by one-way analysis of variance.5.The indices which were related with outcome were analyzed by logistic regression analysis.Results:1.BISmean waspositively correlated with GCS,whereas it was negatively correlated withAPACHE II,S100 and NSE level.2.The gender,age,injuring reasons and APACHE II score had no significant difference between the BIS<60 group and BIS?60 group.The pupil size,GCS score,serum S100 and NSE levels,and the outcome of 28 days had significant difference between the two groups.3.The gender,age and injuring reasons had no significant difference between the survival group and the death group.The pupil size,GCS and APACHE II score,and serum S100 and NSE levels had significant difference between the two groups.4.The logistic regression model showed that BIS was the independent predictor of outcome in DAI patients.Conclusions:BIS can evaluate the severity in patients with DAI,and is a independent predictor of outcome in DAI patients.