Research Reports - Risk factors for myocardial dysfunction after traumatic brain injury

Injury. 2017 Aug;48(8):1794-1800. doi: 10.1016/j.injury.2017.07.004. Epub 2017
Jul 8.

Lu K(1), Liang CL(1), Li PC(2), Liliang PC(1), Huang CY(3), Lee YC(4), Wang
KW(1), Yang SN(2), Sun YT(5), Wang HK(6).

INTRODUCTION: Traumatic brain injury has been associated with an increased risk
of myocardial dysfunction. Common abnormalities accompanying this pathology
include electrocardiographic abnormalities, elevated creatine kinase levels,
arrhythmias, and pathologic changes of the myocardium. The aim of this study was
to determine if TBI patients have a higher risk of myocardial dysfunction than
the general population and to identify the risk factors of myocardial dysfunction
in TBI patients.
PATIENTS AND METHODS: The study sample was drawn from Taiwan's National Health
Insurance Research Database of reimbursement claims, and comprised 26,860
patients who visited ambulatory care centers or were hospitalized with a
diagnosis of TBI. The comparison group consisted of 134,300 randomly selected
individuals. The stratified Fine and Gray regression was performed to evaluate
independent risk factors for myocardial dysfunction in all patients and to
identify risk factors in TBI patients.
RESULTS: During a 1-year follow-up period, 664 patients with TBI and 1494
controls developed myocardial dysfunction. TBI was independently associated with
increased risk of myocardial dysfunction. Diabetes, hypertension, peptic ulcer
disease, chronic liver disease and chronic renal disease were risk factors of
myocardial dysfunction in TBI patients.
CONCLUSIONS: Individuals with TBI are at greater risk of developing myocardial
dysfunction after adjustments for possible confounding factors. Early monitor
should be initiated to decrease disability and dependence in patients with TBI. 

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