Neuroanesthesia & neurocritical care
Dynamic assessment of signal entropy for prognostication and secondary brain insult detection after traumatic brain injury
Authors' conclusion
Biosignal entropy of changes dynamically after TBI. The assessment of these variations augments individualized, dynamic, outcome prognostication and identification of secondary cerebral insults.
Study context
- Population
- Traumatic brain injury (TBI) patients with continuous arterial BP and intracranial pressure (ICP) recordings, clinical information and 6-month outcome (Glasgow Outcome Scale)
- Participants
- 232 continuous recordings
- Outcome
- Association of multiscale entropy (MSE) metrics (percentage monitoring time or dose below cutoffs) with outcome (Glasgow Outcome Scale)
- Follow-up
- 6 months
Methodological detailspropensity score matching, multivariable analysis, Brain Physics database
- Propensity score matching
- Multivariable analysis
- Brain Physics database
Main finding
As reported in the abstract
Poor outcome
Odds ratio (CI)
MSE abp ptime
1.28(1.07–1.58)
MSE cpp ptime
1.50(1.16–2.03)
MSE abp dose
1.12(1.02–1.27)
MSE cpp dose
1.21(1.06–1.46)
Observational data: associations, not effects.
Further findings
Multiscale entropy (MSE) trajectories by outcome
- MSE trajectories differed significantly dependent on outcome
Correlation with clinical parameters
- Weak correlations of entropy metrics to clinical parameters
Secondary brain insults (deviations in ICP, CPP or pressure reactivity)
- Episodes of deranged physiology associated with decreases in MSE metrics from both cerebral and systemic biosignals
Original publication
Dynamic assessment of signal entropy for prognostication and secondary brain insult detection after traumatic brain injury. Crit Care. Published 30 December 2024. doi:10.
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