ArticleScandinavian journal of trauma, resuscitation and emergency medicine2021
Severe traumatic brain injury and hypotension is a frequent and lethal combination in multiple trauma patients in mountain areas - an analysis of the prospective international Alpine Trauma Registry.
Article in Scandinavian journal of trauma, resuscitation and emergency medicine, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers, 1 of them a synthesis that pooled it.
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Who cites it
15 citing papers in PubMed, 1 synthesis or guideline pooled it, 26 citations in OpenAlex.
- Hypotension and Adverse Outcomes in Moderate to Severe Traumatic Brain Injury: A Systematic Review and Meta-Analysis.JAMA network open · 2024Pooled it
- Key strategies in trauma anesthesia for severe hemorrhage: a narrative review.Korean journal of anesthesiology · 2026Review
- Article
- Impact of Prehospital Blood Pressure Profile on Functional Outcome After Traumatic Brain Injury.Journal of clinical medicine · 2025Article
- High-altitude HEMS missions-a retrospective analysis of 3,564 air rescue missions conducted between 2011 and 2021.Scandinavian journal of trauma, resuscitation and emergency medicine · 2025Article
- Comparison of the lethal triad and the lethal diamond in severe trauma patients: a multicenter cohort.World journal of emergency surgery : WJES · 2025Article
- TERMINAL-24 Score in Predicting Early and In-hospital Mortality of Trauma Patients; a Cross-sectional.Archives of academic emergency medicine · 2025Article
- RELATIONSHIP BETWEEN TRPM4 RS8104571 GENOTYPE, CIRCULATING TRPM4 AND SUR1, AND CLINICAL OUTCOME FOLLOWING TRAUMATIC BRAIN INJURY.Shock (Augusta, Ga.) · 2025Article
- Article
- Observational
- Article
- Induction of pre-hospital emergency anaesthesia i-PHEA: a national survey of UK HEMS practice.BMC emergency medicine · 2023Article
- Eight rules for the haemodynamic management of traumatic brain-injured patients.European journal of anaesthesiology and intensive care · 2023Article
- Association between pre-hospital National Early Warning Score and in-hospital mortality in patients with traumatic brain injury.Ulusal travma ve acil cerrahi dergisi = Turkish journal of trauma & emergency surgery : TJTES · 2023Observational
- Evaluating Thera-101 as a Low-Volume Resuscitation Fluid in a Model of Polytrauma.International journal of molecular sciences · 2022Article
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Authors and funding
9 authors at 3 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundHypotension is associated with worse outcome in patients with traumatic brain injury (TBI) and maintaining a systolic blood pressure (SBP) ≥110 mmHg is recommended. The aim of this study was to assess the incidence of TBI in patients suffering multiple trauma in mountain areas; to describe associated factors, treatment and outcome compared to non-hypotensive patients with TBI and patients without TBI; and to evaluate pre-hospital variables to predict admission hypotension.
methodsData from the prospective International Alpine Trauma Registry including mountain multiple trauma patients (ISS ≥ 16) collected between 2010 and 2019 were analysed. Patients were divided into three groups: 1) TBI with hypotension, 2) TBI without hypotension and 3) no TBI. TBI was defined as Abbreviated Injury Scale (AIS) of the head/neck ≥3 and hypotension as SBP < 110 mmHg on hospital arrival.
resultsA total of 287 patients were included. Fifty (17%) had TBI and hypotension, 92 (32%) suffered TBI without hypotension and 145 (51%) patients did not have TBI. Patients in group 1 were more severely injured (mean ISS 43.1 ± 17.4 vs 33.3 ± 15.3 vs 26.2 ± 18.1 for group 1 vs 2 vs 3, respectively, p < 0.001). Mean SBP on hospital arrival was 83.1 ± 12.9 vs 132.5 ± 19.4 vs 119.4 ± 25.8 mmHg (p < 0.001) despite patients in group 1 received more fluids. Patients in group 1 had higher INR, lower haemoglobin and lower base excess (p < 0.001). More than one third of patients in group 1 and 2 were hypothermic (body temperature < 35 °C) on hospital arrival while the rate of admission hypothermia was low in patients without TBI (41% vs 35% vs 21%, for group 1 vs 2 vs 3, p = 0.029). The rate of hypothermia on hospital arrival was different between the groups (p = 0.029). Patients in group 1 had the highest mortality (24% vs 10% vs 1%, p < 0.001).
conclusionMultiple trauma in the mountains goes along with severe TBI in almost 50%. One third of patients with TBI is hypotensive on hospital arrival and this is associated with a worse outcome. No single variable or set of variables easily obtainable at scene was able to predict admission hypotension in TBI patients.
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