Electrocardiographic Changes in Patients with Isolated Traumatic Brain Injury and Their Correlation with Outcome

Abstract

Objectives Electrocardiography (ECG) can be used as an inexpensive tool to identify high-risk patients who are at risk of developing cardiac dysfunction following traumatic brain injury (TBI). In the present article, we report our experience with the incidence of electrocardiographic changes in patients with TBI patients and their correlation with overall outcome.

Materials and Methods All the patients who were admitted with the diagnosis of TBI under neurosurgery were included in the study. Clinical details and 12 lead ECG details for any ECG abnormalities (rhythm abnormalities, conduction abnormalities, QRS ST complex abnormalities, nonspecific ST changes, QT interval abnormalities, and data regarding outcome) were recorded. The data were entered into a spreadsheet and analyzed using StatsDirect version 3 statistical analysis software. Data were expressed using descriptive statistics—frequency and percentage for categorical variables. Pearson chi-square test was used to identify significance. p < 0.05 was considered significant.

Results A total of 109 patients and same number of admission ECGs were available for interpretation. Mild head injury was most common (65.1%) followed by severe (18.3%) and moderate (15.6%) head injuries. ECG results were normal in 97 patients and were abnormal in 12 patients. Statistical analysis showed that the correlation among severity of the head injury, ECG results, and outcome was significant. However, there was no significant correlation between QTc and outcome, and correlation between severity of head injury and outcome.

Conclusion The present study highlights the need to recognize the importance of ECG as a simple tool to identify the cardiovascular changes in patients with TBI. However, there is a need to conduct further prospective studies to supplement these findings with changes in the levels of cardiac enzymes or associated echocardiography abnormalities and their correlation with ECG findings and overall outcome.

Keywords

traumatic brain injury - cardiac function - electrocardiography - QTc interval

• References

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