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Original Research | Open Access

Optimal range of systolic blood pressure in the emergent phase that reduces the negative outcomes of traumatic brain injury surgery

Gang Zhu,†( ), Fan Chen,†, Liang Wang, Wenxing Cui, Yaning Cai, Chen Yang, Zhihong Li, Yan Qu, Shunnan Ge( )
Department of Neurosurgery, Tangdu Hospital, Xi'an 710038, Shaanxi, China

† These authors have contributed equally to this work and share first authorship.

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Abstract

Background

Blood pressure management is critical for the treatment of traumatic brain injury (TBI). The purpose of this study was to determine the safe systolic blood pressure (SBP) range during the emergent phase that reduces negative outcomes after TBI surgery.

Methods

Patients with isolated TBI who received surgical treatment were enrolled. We retrospectively analyzed the outcomes of the TBI patients with different admission SBP (mmHg) ranges. In addition, the safe SBP ranges for patients in different age groups (<50 or ≥50 years old) were identified.

Results

Among the TBI patients, those with an admission SBP ranging from 100 to 140 mmHg had the lowest mortality rate: 18.97% for the 100–120-mmHg group and 19.52% for the 120–140-mmHg group. Among the patients with an admission SBP of ≥140 mmHg, the mortality rate decreased dramatically when the SBP was controlled to 100–140 mmHg during the emergent phase (22.22% vs. 37.542%, p = 0.022). However, this control had no effect on the extended Glasgow outcome scale (GOSE) score of the survivals (p = 0.920). Multivariate regression analysis further revealed that an admission SBP of 100–140 mmHg is an independent factor for favorable outcomes, but only in patients who are ≥50 years old (p = 0.017).

Conclusions

This study identified the optimal range of SBP during the emergent phase for isolated TBI patients. We emphasize the beneficial effects of reducing blood pressure before surgery in TBI, especially for patients who are ≥50 years old. The study provides new evidence for a blood pressure management target in TBI.

Keywords

MortalityTraumatic brain injuryPrognosisBlood pressureEmergency surgery

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Journal of Neurorestoratology
Volume 12 Issue 2,
June 2024
Article number: 100118
DOI: 10.1016/j.jnrt.2024.100118
Cite this article:
Zhu G, Chen F, Wang L, et al. Optimal range of systolic blood pressure in the emergent phase that reduces the negative outcomes of traumatic brain injury surgery. Journal of Neurorestoratology, 2024, 12(2): 100118. https://doi.org/10.1016/j.jnrt.2024.100118

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Received: 01 November 2023
Revised: 23 January 2024
Accepted: 12 March 2024
Published: 10 April 2024
© 2024 The Authors.

This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).
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