Influencing factors on neurological prognosis after traumatic brain injury and the role of brain tissue oxygen pressure (PbtO₂) monitoring

Objective: To identify factors influencing neurological prognosis following traumatic brain injury (TBI) and to analyze the role of brain tissue oxygen pressure (PbtO₂) monitoring in prognostication.

Methods: In this case-control study, medical records of 412 individuals diagnosed with TBI were thoroughly examined and analyzed. The patients were divided into two groups based on their prognosis at three months post-injury: Good Prognosis (n = 321) and Poor Prognosis (n = 91). Demographic and clinical characteristics, brain tissue oxygen partial pressure, radiological and laboratory findings, treatment interventions, and complications were compared between the two groups. Logistic regression analysis was conducted to identify the risk factors for neurological prognosis, and the predictive value of these factors was evaluated using receiver operating characteristic (ROC) curve analysis.

Results: The study identified associations between Injury Severity Score (ISS), Glasgow Coma Scale (GCS), PbtO₂ levels, radiological findings (diffuse axonal injury and subarachnoid hemorrhage), and laboratory parameters (platelet count and arterial oxygen partial pressure (PaO₂)) with neurological prognosis following TBI. Initial PbtO₂ levels demonstrated independent predictive value for poor neurological outcomes (Area Under the Curve (AUC) = 0.804).

Conclusion: The study highlights the prognostic significance of injury severity, brain tissue oxygenation, radiological findings, and laboratory parameters in determining neurological outcomes following TBI. Furthermore, the findings emphasize the potential of PbtO₂ monitoring as a valuable tool in prognostic assessment.