AUTHOR=Wang Xin-Cai , Gao Shang-Jun , Zhuo Shi-Long , Weng Cui-Lian , Feng Hang-Wei , Lin Jian , Lin Xing-Sheng , Huang Long 

TITLE=Predictive factors for cerebrocardiac syndrome in patients with severe traumatic brain injury: a retrospective cohort study

JOURNAL=Frontiers in Neurology

VOLUME=Volume 14 - 2023

YEAR=2023

URL=https://www.frontiersin.org/journals/neurology/articles/10.3389/fneur.2023.1192756

DOI=10.3389/fneur.2023.1192756

ISSN=1664-2295

ABSTRACT=Background and Objective: Cerebrocardiac syndrome (CCS) is a severe complication of severe traumatic brain injury (sTBI) that carries high mortality and disability rates. Early identification of CCS poses a significant clinical challenge. The main objective of this study was to investigate potential risk factors associated with the development of secondary CCS in patients with sTBI. 
Methods :A retrospective cohort study was conducted to identify risk factors for CCS secondary to sTBI. This study involved the analysis and comparison of clinical data from two patient groups.Multivariate logistic regression was employed to identify independent risk factors for CCS, and receiver operating characteristic (ROC) curves were used to assess their predictive value for CCS secondary to sTBI.
Results :The study revealed that 48.4% of sTBI patients developed secondary CCS. In multivariate analysis model 2 that includes NT-proBNP and cTnI，cTnI (OR=27.711, 95%CI: 3.086-248.795, P=0.003), right heart Tei index (OR=2.736, 95% CI: 1.056-7.091, P=0.038), and GCS (OR=0.147, 95% CI: 0.045-0.481, P=0.002) were independent risk factors for secondary CCS in sTBI patients.
The area under the ROC curve for ONSD, Tei index, GCS, and cTnI were 0.596, 0.613, 0.635, and 0.881, respectively. ONSD exhibited a positive predictive value (PPV) of 0.704 and a negative predictive value (NPV) of 0.634. The Tei index demonstrated a PPV of 0.624 and an NPV of 0.726, while GCS had a PPV of 0.644 and an NPV of 0.815. On the other hand, cTnI exhibited a significantly higher PPV of 0.936 and an NPV of 0.817. These findings indicate that the Tei index, GCS score, and cTnI possess certain predictive value for secondary CCS in patients with sTBI.
Conclusions:The study provides valuable insights into the identification of independent risk factors for CCS secondary to sTBI. The findings highlight the significance of right heart Tei index, GCS score,and cTnI as potential predictive factors for CCS in sTBI patients. Further larger-scale studies are warranted to corroborate these findings and to provide robust evidence for the development of early intervention strategies aimed at reducing the incidence of CCS in this patient population.