In traumatic brain injury (TBI), preliminary retrospective work on signal entropy suggests an association with global outcome. The goal of this study was to provide multi-center validation of the association between multi-scale entropy (MSE) of cardiovascular and cerebral physiological signals, with six-month outcome. Using the Collaborative European NeuroTrauma Effectiveness Research in TBI (CENTER-TBI) high-resolution intensive care unit (ICU) cohort, we selected patients with a minimum of 72 h of physiological recordings and a documented six-month Glasgow Outcome Scale Extended (GOSE) score. The 10-sec summary data for heart rate (HR), mean arterial pressure (MAP), intracranial pressure (ICP), and pulse amplitude of ICP (AMP) were derived across the first 72 h of data. The MSE complexity index (MSE-Ci) was determined for HR, MAP, ICP, and AMP, with the association between MSE and dichotomized six-month outcomes assessed using Mann-Whitney U testing and logistic regression analysis. A total of 160 patients had a minimum of 72 h of recording and a documented outcome. Decreased HR MSE-Ci (7.3 [interquartile range (IQR) 5.4 to 10.2] vs. 5.1 [IQR 3.1 to 7.0]; p = 0.002), lower ICP MSE-Ci (11.2 [IQR 7.5 to 14.2] vs. 7.3 [IQR 6.1 to 11.0]; p = 0.009), and lower AMP MSE-Ci (10.9 [IQR 8.0 to 13.7] vs. 8.7 [IQR 6.6 to 11.0]; p = 0.022), were associated with death. Similarly, lower HR MSE-Ci (8.0 [IQR 6.2 to 10.9] vs. 6.2 [IQR 3.9 to 8.7]; p = 0.003) and lower ICP MSE-Ci (11.4 [IQR 8.6 to 14.4)] vs. 9.2 [IQR 6.0 to 13.5]), were associated with unfavorable outcome. Logistic regression analysis confirmed that lower HR MSE-Ci and ICP MSE-Ci were associated with death and unfavorable outcome at six months. These findings suggest that a reduction in cardiovascular and cerebrovascular system entropy is associated with worse outcomes. Further work in the field of signal complexity in TBI multi-modal monitoring is required.

中文翻译：

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生理信号复杂性与中度和重度创伤性脑损伤结果之间的关联：多尺度熵的 CENTER-TBI 探索性分析。

在创伤性脑损伤 (TBI) 中，对信号熵的初步回顾性工作表明与整体结果相关。本研究的目的是提供多中心验证心血管和大脑生理信号的多尺度熵 (MSE) 与六个月结果之间的关联。使用 TBI（CENTER-TBI）高分辨率重症监护病房 (ICU) 队列中的欧洲神经创伤协作有效性研究，我们选择了至少 72 小时生理记录和记录的 6 个月格拉斯哥结局扩展 (GOSE) 的患者分数。心率 (HR)、平均动脉压 (MAP)、颅内压 (ICP) 和 ICP (AMP) 脉搏幅度的 10 秒汇总数据来自前 72 小时的数据。确定了 HR、MAP、ICP 和 AMP 的 MSE 复杂性指数 (MSE-Ci)，U检验和逻辑回归分析。总共 160 名患者有至少 72 小时的记录和记录的结果。HR MSE-Ci 降低（7.3 [四分位距 (IQR) 5.4 至 10.2] 与 5.1 [IQR 3.1 至 7.0]；p  = 0.002），ICP MSE-Ci 降低（11.2 [IQR 7.5 至 14.2] 与 7.2） 6.1 至 11.0]；p  = 0.009）和较低的 AMP MSE-Ci（10.9 [IQR 8.0 至 13.7] vs. 8.7 [IQR 6.6 至 11.0]；p  = 0.022）与死亡相关。同样，较低的 HR MSE-Ci（8.0 [IQR 6.2 至 10.9] 与 6.2 [IQR 3.9 至 8.7]；p = 0.003) 和较低的 ICP MSE-Ci（11.4 [IQR 8.6 至 14.4）] 对比 9.2 [IQR 6.0 至 13.5]），与不利的结果相关。Logistic 回归分析证实，较低的 HR MSE-Ci 和 ICP MSE-Ci 与 6 个月时的死亡和不良结局相关。这些发现表明，心脑血管系统熵的降低与更差的结果相关。需要在 TBI 多模态监测中的信号复杂性领域进一步开展工作。