CEREBRAL OXIMETRY AS A PREDICTOR OF THE OUTCOME OF THE DISEASE IN PATIENTS WITH SECONDARY BRAIN LESIONS

Sarkulova Zh.N. Tokshilykova A.B. Sarkulov M.N. Tleuova A.S. Kalieva B.M. Daniyarova K.R. Zhankulov M.H. Zhienalin R.N. Kiliptary G.
October 2022 Georgian Association of Business Press

Georgian Medical News
2022 #331 Issue 10 116 - 123 pp.

This study is devoted to the study of the prognostic value of cerebral oximetry of the brain and indicators of the outcome of brain damage. The purpose of the study: To study the prognostic role of cerebral oximetry indicators as a predictor of mortality in vascular and traumatic brain injuries. Materials and methods: A prospective cohort study involving 129 patients. Cerebral gas exchange and oxygenation, arteriovenous difference, neuron-specific markers (S100ß, NSE) and glucose, acid-base state and gas composition of arterial blood were studied during follow-up periods: at admission, on the 3^rd, 5^th and 7^th days of patients stay in the intensive care unit. Results: The most significant risk factor for an unfavorable outcome is a marker with a threshold value or with a cut-off point rSO₂<45%. Statistically significant direct connections were determined between dependent rSO₂<45% with independent variables, such as: S100ß<0.6 mcg/l - OR is 4.22 (95%CI:10.76-1.66), p=0.0025; joining in a patient with a diagnosis of pneumonia - OR 6.21(95% CI:12.0-3.21), p<0.0001 and the patients diagnosis was 8.13 (95% CI:25.59-2.59), p=0.0003. The measure of certainty of the obtained model was according to the criterion of pseudo R2 Nagelkerke -137.8; log Likelihood - 175.83. The cut-off point of 97.1% had the best predictive value of the model, the area under the AuROC curve was 0.846; sensitivity - 68.47%; specificity - 90.16%; NPV - 61.11%; PPV - 92.68%. The quantitative indicator rSO₂ was obtained in relation to the independent variables GCS, ABP, NSE and pH and the quality characteristic of the model has: R2 = 16.7%; R2 (adjusted) = 15.5%; p <0.0001. This model can be used to predict the outcome in patients with acute cerebral pathology.

cerebral oximetry , diagnostic and prognostic criteria , stroke outcome , Strokes , traumatic brain injuries

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West Kazakhstan Medical University named after Marat Ospanov, Kazakhstan

West Kazakhstan Medical University named after Marat Ospanov

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