Impact of Left Ventricular Systolic Function After Moderate-to-Severe Isolated Traumatic Brain Injury: A Systematic Review and Meta-Analysis.

ABSTRACT

Traumatic brain injury (TBI) can result in left ventricular dysfunction, which can lead to hypotension and secondary brain injuries. However, the association between left ventricular systolic dysfunction (LVSD) and in-hospital mortality in patients with moderate-to-severe isolated TBI is controversial. Therefore, we conducted a systematic review and meta-analysis to identify the prevalence of LVSD and evaluate whether LVSD following moderate-to-severe isolated TBI increases the in-hospital mortality. We searched PubMed, EMBASE, and the Cochrane Library database from January 1, 2010, through June 30, 2020. Meta-analysis was performed to determine the incidence of LVSD and related mortality in patients with moderate-to-severe isolated TBI. A systematic review identified 5 articles appropriate for meta-analysis. The total number of patients pooled was 256. LVSD was reported in 4 studies, of which the estimated incidence of patients with LVSD was 18.7% (95% confidence interval, 11.9-26.6). Five studies reported on in-hospital mortality, and the estimated in-hospital mortality was 14.1% (95% confidence interval, 5.3-25.6). Finally, 3 studies were eligible for analyzing the association of LVSD and in-hospital mortality. On meta-analysis, in-hospital mortality was significantly higher in patients with LVSD (risk ratio, 6.57; 95% confidence interval, 3.71-11.65; P < 0.001). In conclusion, LVSD after moderate-to-severe TBI is common and may be associated with worse in-hospital outcomes.