This study adopts a retrospective design, continuously including patients with TBI treated at the Emergency Trauma Center of the First Affiliated Hospital of Suzhou University from May 2017 to September 2024. Investigators used the hospital's electronic medical record system to collect clinical data. The patients' age, gender, history of diabetes, history of hypertension, medication history, mechanism of injury, mean arterial pressure, Glasgow Coma Scale, and other information were recorded upon emergency admission. Laboratory indicators included white blood cell count, hemoglobin (HB) levels, platelet count, C-reactive protein, international normalized ratio (INR), and albumin. Myocardial injury markers included alpha-hydroxybutyrate dehydrogenase, creatine kinase, lactate dehydrogenase, aspartate aminotransferase, creatine kinase-MB (CK-MB), myoglobin, NT-pro BNP, and high-sensitivity troponin T. Additionally, continuous ECG monitoring was conducted for 24 hours after admission.
This study adopts a retrospective design, continuously including patients with TBI treated at the Emergency Trauma Center of the First Affiliated Hospital of Suzhou University from May 2017 to September 2024. Investigators used the hospital's electronic medical record system to collect clinical data. The patients' age, gender, history of diabetes, history of hypertension, medication history, mechanism of injury, mean arterial pressure, Glasgow Coma Scale, and other information were recorded upon emergency admission. Laboratory indicators included white blood cell count, hemoglobin (HB) levels, platelet count, C-reactive protein, international normalized ratio (INR), and albumin. Myocardial injury markers included alpha-hydroxybutyrate dehydrogenase, creatine kinase, lactate dehydrogenase, aspartate aminotransferase, creatine kinase-MB (CK-MB), myoglobin, NT-pro BNP, and high-sensitivity troponin T. Additionally, continuous ECG monitoring was conducted for 24 hours after admission.
Study Type
OBSERVATIONAL
Enrollment
172
Department of Emergency Medicine，the First Affiliated Hospital of Soochow University.
Suzhou, Jiangsu, China
Glasgow Outcome Score
Glasgow Outcome Score 1. Dead: As a direct result of brain trauma, or due to secondary complications, or other complications 2. Vegetative State: Patients who remain unresponsive and speechless…. 3， Severe Disability: The patient is conscious but needs the assistance of another person for some activities of daily living every day 4， Moderate Disability: Such a patient can look after himself at home, get out and about to the shops, and travel by public transport. However, some previous activities, either at work or in social life, are now no longer possible because of either physical or mental deficit 5， Good Recovery: This indicates the capacity to resume normal occupational and social activities, although minor physical or mental deficits may exist. Social outcomes should be included in the assessment here, such as leisure activities and family relationships.
Time frame: 6 months after discharge
Standard deviation of all NN intervals（SDNN）
This metric measures the standard deviation of normal beat-to-beat intervals (SDNN) present within the heart rhythm. It is a time domain measure of heart rate variability（HRV）, and it serves as a marker of overall adaptability of the nervous system.
Time frame: Day 1 post-TBI.
The average of all 5-minute standard deviations of NN intervals across a 24-hour period (SDNN index)
The average of all 5-minute standard deviations of NN intervals across 24 hours (SDNN index). Reflects combined parasympathetic and sympathetic modulation
Time frame: day 1 post TBI
The root mean square of successive differences between NN intervals (RMSSD)
The Root Mean Square of Successive Differences between NN intervals (RMSSD) quantifies the variability in time intervals between consecutive normal heartbeats (NN intervals) on an electrocardiogram (ECG). Reflects parasympathetic (vagal) tone, as it captures rapid, beat-to-beat changes in heart rate mediated by the autonomic nervous system. A higher RMSSD indicates greater HRV and adaptability of the cardiovascular system, often associated with better stress resilience and recovery.
Time frame: Day 1 post-TBI
The proportion of consecutive NN intervals differing by over 50 ms, relative to the total number of NN intervals (pNN50)
A higher pNN50 indicates greater parasympathetic dominance. A lower pNN50 suggests reduced vagal tone, common in stress, aging, or pathologies.
Time frame: day 1 post-TBI
Triangle index
The Triangle Index is a global measure of heart rate variability derived from the geometric properties of an NN interval histogram. A higher value indicates greater overall HRV, reflecting healthy autonomic nervous system function.
Time frame: day 1 post TBI
HRV High Frequency Power
Baseline level of High Frequency HRV power (0.15-0.4 Hz) measured in ms2/Hz recorded on day 1 of TBI
Time frame: Day 1 post-TBI
HRV low frequency power
Low-frequency (LF) power (typically 0.04-0.15 Hz) is a spectral component of HRV reflecting mixed sympathetic and parasympathetic influences on heart rate, with potential contributions from baroreflex activity.
Time frame: Day 1 post- TBI
HRV very low frequency power
VLF (Very-Low-Frequency) power is a spectral component of heart rate variability (HRV) in the 0.0033-0.04 Hz range (or sometimes \<0.05 Hz). VLF is linked to long-term autonomic and neurohormonal control.
Time frame: Day 1 post- TBI
Glasgow Coma Scale
Its values range from 3 to 15. 13 to 15: Mild traumatic brain injury (mTBI). 9 to 12: Moderate TBI.3 to 8: Severe TBI.
Time frame: On Day 1 after TBI onset
Hypertension history
Time frame: On Day 1 after TBI onset
Diabetes history
Time frame: On Day 1 after TBI onset
Age
Time frame: Baseline
White Blood Cell Count
White Blood Cell (WBC) count refers to the measurement of the total number of white blood cells (leukocytes) per microliter (µL) or cubic millimeter (mm³) of blood. These cells are a crucial component of the immune system, playing essential roles in defending the body against infections, foreign substances, and diseases.
Time frame: On Day 1 after TBI onset
Hemoglobin
Hemoglobin (Hb or Hgb) is an iron-containing protein found in red blood cells (RBCs) that binds oxygen in the lungs and delivers it to tissues throughout the body while also transporting carbon dioxide back to the lungs for exhalation.
Time frame: On Day 1 after TBI onset
Platelets (thrombocytes)
Platelets (thrombocytes) are small, colorless cell fragments in the blood that play a crucial role in clotting and stopping bleeding. The platelet count (PLT) measures the number of platelets per microliter (μL) of blood.
Time frame: On Day 1 after TBI onset
C-Reactive Protein (CRP)
C-reactive protein (CRP) is a liver-produced protein that increases rapidly in response to inflammation, infection, or tissue damage. It is a key acute-phase reactant used to detect and monitor inflammatory conditions.
Time frame: On Day 1 after TBI onset
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International Normalized Ratio
Time frame: On Day 1 after TBI onset
Albumin
Time frame: On Day 1 after TBI onset
Alpha-Hydroxybutyrate Dehydrogenase
Time frame: On Day 1 after TBI onset
Creatine Kinase
Time frame: On Day 1 after TBI onset
Lactate Dehydrogenase
Time frame: On Day 1 after TBI onset
Aspartate Aminotransferase
Time frame: On Day 1 after TBI onset
Creatine Kinase-MB
Time frame: On Day 1 after TBI onset
Myoglobin
Time frame: On Day 1 after TBI onset
N-Terminal pro-BNP
Time frame: On Day 1 after TBI onset
High-Sensitivity Troponin T
Time frame: On Day 1 after TBI onset