International journal of burns and trauma · 2026
Evaluating the electrocardiographic abnormalities in traumatic brain injury: prevalence, severity correlation, and outcome prediction.
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Mojahedi Azad, Gunsburg Moshe, Friedman Adam, Abomohsen Mustafa, Farid Meena, Idries Iyad, Chadow Hal
Аннотация
BACKGROUND: Traumatic brain injury (TBI) induces systemic responses, including neurogenic cardiac injury via the brain-heart axis, manifesting as electrocardiographic (ECG) abnormalities that may predict outcomes.
OBJECTIVE: This systematic review aimed to evaluate the diagnostic and prognostic utility of ECG monitoring in patients with TBI, identify knowledge gaps, and guide future research.
METHODS: Following PRISMA guidelines, we searched PubMed and Google Scholar (January 2020 - March 2025) for studies on adult patients with TBI (≥ 16 years) who underwent acute ECG assessment (≤ 72 hours post-injury). The inclusion criteria focused on observational/cohort studies that reported ECG changes, severity correlations, and outcomes. The exclusion criteria were pediatric cases, pre-existing cardiac conditions, and non-English articles. Data were extracted from the eligible studies.
RESULTS: Six studies (1,642 patients) revealed ECG abnormalities in 10-88% of cases, increasing with TBI severity (e.g., prolonged QTc in 3% of mild cases vs. 15% of severe cases). Common changes included repolarization issues (QTc prolongation and ST-segment/T-wave alterations), arrhythmias, and conduction disturbances. Abnormalities often resolved within days, improved post-neurosurgery (e.g., reduced QTc), and predicted mortality (e.g., QTc prolongation/ST depression as independent factors) and cardiac dysfunction.
CONCLUSION: ECG changes are prevalent in TBI, correlate with severity, and have prognostic value for risk stratification. Routine monitoring is recommended, and larger, standardized studies are needed to optimize management.
OBJECTIVE: This systematic review aimed to evaluate the diagnostic and prognostic utility of ECG monitoring in patients with TBI, identify knowledge gaps, and guide future research.
METHODS: Following PRISMA guidelines, we searched PubMed and Google Scholar (January 2020 - March 2025) for studies on adult patients with TBI (≥ 16 years) who underwent acute ECG assessment (≤ 72 hours post-injury). The inclusion criteria focused on observational/cohort studies that reported ECG changes, severity correlations, and outcomes. The exclusion criteria were pediatric cases, pre-existing cardiac conditions, and non-English articles. Data were extracted from the eligible studies.
RESULTS: Six studies (1,642 patients) revealed ECG abnormalities in 10-88% of cases, increasing with TBI severity (e.g., prolonged QTc in 3% of mild cases vs. 15% of severe cases). Common changes included repolarization issues (QTc prolongation and ST-segment/T-wave alterations), arrhythmias, and conduction disturbances. Abnormalities often resolved within days, improved post-neurosurgery (e.g., reduced QTc), and predicted mortality (e.g., QTc prolongation/ST depression as independent factors) and cardiac dysfunction.
CONCLUSION: ECG changes are prevalent in TBI, correlate with severity, and have prognostic value for risk stratification. Routine monitoring is recommended, and larger, standardized studies are needed to optimize management.