Observational studyCritical care (London, England)2017
Catecholamines as outcome markers in isolated traumatic brain injury: the COMA-TBI study.
Observational study in Critical care (London, England), 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04515420 (The Influence of Noradrenaline Infusion on Coagulation and Fibrinolysis in Patients With Isolated Severe Brain Injury), which is not on this map. Cited by 56 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
The Influence of Noradrenaline Infusion on Coagulation and Fibrinolysis in Patients With Isolated Severe Brain Injury
Who cites it
56 citing papers in PubMed, 2 syntheses or guidelines pooled it, 118 citations in OpenAlex.
- Preclinical Studies on Mechanisms Underlying the Protective Effects of Propranolol in Traumatic Brain Injury: A Systematic Review.Journal of neuroimmune pharmacology : the official journal of the Society on NeuroImmune Pharmacology · 2024Pooled it
- Beta blockers in traumatic brain injury: a systematic review and meta-analysis.Trauma surgery & acute care open · 2023Pooled it
- Early Intravenous Beta-Blockade with Esmolol in Adults with Severe Traumatic Brain Injury: A Phase 2a Intervention Design Study.Neurocritical care · 2024Trial
- Systemic and cerebro-cardiac biomarkers following traumatic brain injury: an interim analysis of randomized controlled clinical trial of early administration of beta blockers.Scientific reports · 2024Trial
- Implementation of hyperspectral imaging in a trauma resuscitation room: a randomized controlled trial.Scandinavian journal of trauma, resuscitation and emergency medicine · 2022Trial
- Cardiac Dysfunction in Blunt Traumatic Brain Injury Patients.Critical care explorations · 2026Article
- Gastrointestinal Dysfunction in Critically Ill Patients With Traumatic Brain Injury: Clinical Implications and Putative Mechanisms: a Narrative Review.Current neurology and neuroscience reports · 2026Review
- Article
- Glymphatic dysfunction: a unifying hypothesis for delirium.Nature reviews. Neurology · 2026Review
- Do Serum Brain Biomarkers Differentiate the Hemorrhagic Head Injury Lesion Phenotypes? An Interim Analysis of an On-Going Randomized Clinical Trial.Biomedicines · 2026Article
- Neuro-immune dysregulation after traumatic brain injury: immunomodulatory strategies to prevent infectious complications.Frontiers in molecular neuroscience · 2026Review
- Dysregulated sympathovagal interplay contributes to gastric mucosal injury following subarachnoid hemorrhage.Frontiers in neuroscience · 2026Article
- Beta-blockers in adults with acute traumatic brain injury: a systematic review and meta-analysis of randomized controlled trials.Journal of anesthesia, analgesia and critical care · 2025Review
- Perceiving traumatic brain injury from glymphatic system.Molecular psychiatry · 2025Review
- Bidirectional Interplay Between Traumatic Brain Injury and Cardiovascular Dysfunction in Athletes.Journal of clinical medicine · 2025Review
- A Comprehensive Review of Fluid Resuscitation Strategies in Traumatic Brain Injury.Journal of clinical medicine · 2025Review
- Neuroinflammatory Signature of Post-Traumatic Confusional State: The Role of Cytokines in Moderate-to-Severe Traumatic Brain Injury.International journal of molecular sciences · 2025Article
- Heart Rate Variability and Cerebral Autoregulation in Patients with Traumatic Brain Injury with Paroxysmal Sympathetic Hyperactivity Syndrome.Neurocritical care · 2025Article
- Lasting Impact: Exploring the Brain Mechanisms that Link Traumatic Brain Injury to Parkinson's Disease.Molecular neurobiology · 2025Review
- CSF transport at the brain-meningeal border: effects on neurological health and disease.The Lancet. Neurology · 2025Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
12 authors at 6 institutions in 4 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundElevated catecholamine levels might be associated with unfavorable outcome after traumatic brain injury (TBI). We investigated the association between catecholamine levels in the first 24 h post-trauma and functional outcome in patients with isolated moderate-to-severe TBI.
methodsA cohort of 174 patients who sustained isolated blunt TBI was prospectively enrolled from three Level-1 Trauma Centers. Epinephrine (Epi) and norepinephrine (NE) concentrations were measured at admission (baseline), 6, 12 and 24 h post-injury. Outcome was assessed at 6 months by the extended Glasgow Outcome Scale (GOSE) score. Fractional polynomial plots and logistic regression models (fixed and random effects) were used to study the association between catecholamine levels and outcome. Effect size was reported as the odds ratio (OR) associated with one logarithmic change in catecholamine level.
resultsAt 6 months, 109 patients (62.6%) had an unfavorable outcome (GOSE 5-8 vs. 1-4), including 51 deaths (29.3%). Higher admission levels of Epi were associated with a higher risk of unfavorable outcome (OR, 2.04, 95% CI: 1.31-3.18, p = 0.002) and mortality (OR, 2.86, 95% CI: 1.62-5.01, p = 0.001). Higher admission levels of NE were associated with higher risk of unfavorable outcome (OR, 1.59, 95% CI: 1.07-2.35, p = 0.022) but not mortality (OR, 1.45, 95% CI: 0.98-2.17, p = 0.07). There was no relationship between the changes in Epi levels over time and mortality or unfavorable outcome. Changes in NE levels with time were statistically associated with a higher risk of mortality, but the changes had no relation to unfavorable outcome.
conclusionsElevated circulating catecholamines, especially Epi levels on hospital admission, are independently associated with functional outcome and mortality after isolated moderate-to-severe TBI.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.