Study on the prognostic value of dynamic changes in the lindegaard ratio monitored by transcranial doppler in traumatic brain injury-related cerebral vasospasm.

OBJECTIVE

To study the application value of Lindegaard ratio evolution trajectory monitored by transcranial Doppler ultrasound (TCD) in predicting the prognosis of cerebral vasospasm (CVS) after traumatic brain injury (TBI), and to provide reference for early clinical improvement of prognosis.

METHODS

A total of 194 patients with CVS after TBI admitted to China Tianjin Huanhu Hospital from February 2022 to May 2024 were selected. The evolution trajectory of Lindegaard ratio on the 1st, 3rd, 7th and 14 th day of TCD monitoring of CVS patients after TBI was analyzed. The clinical data and Lindegaard ratio trajectory of different prognostic groups were compared, and the predictive value of Lindegaard ratio evolution trajectory on the prognosis of CVS patients after TBI was analyzed.

RESULTS

The Lindegaard ratio showed an increasing trend from day 1 to day 7, and decreased at day 14 (P < 0.05). The Lindegaard ratio of the high trajectory subgroup was higher than that of the median trajectory subgroup and the low trajectory subgroup on the 1st, 3rd, 7th and 14th day of treatment (P < 0.05). There were significant differences in Glasgow Coma Scale (GCS) score, epidural hematoma, CVS severity, Fisher grade, Lindegaard ratio trajectory and multiple trauma between the two groups with different prognosis (P < 0.05). GCS score at admission, epidural hematoma, severity of CVS, Fisher grade, Lindegaard ratio trajectory, and multiple injuries were all independent influencing factors of poor prognosis in patients with CVS after TBI (P < 0.05). The GCS score at admission, epidural hematoma, severity of CVS, Fisher grade, Lindegaard ratio trajectory, and multiple injuries were analyzed. The results showed that the AUC of the combination of the above indicators in predicting the prognosis of patients with CVS after TBI was 0.772 (95%CI: 0.697-0.848).

CONCLUSIONS

TCD monitoring of Lindegaard ratio evolution trajectory can effectively predict the prognosis of patients with CVS after TBI. Among them, the risk of poor prognosis in patients with high Lindegaard ratio trajectory is significantly increased, which can provide reference for clinical individualized intervention and improvement of patient prognosis.