Prognostic utility of on-admission pulse pressure in hospitalized patients with traumatic brain injury

doi:10.5492/wjccm.115627

Advanced Search

BPG is committed to discovery and dissemination of knowledge

Home / Archive / Volume 15, Issue 3

This Article

(4)

(0)

(1)

(65)

Peer-Review Report of This Article

CrossCheck and Google Search of This Article

Academic Rules and Norms of This Article

Citation of this article

Corresponding Author of This Article

Research Domain of This Article

Article-Type of This Article

Open-Access Policy of This Article

Times Cited Counts in Google of This Article

Journal Information of This Article

Publication Name

World Journal of Critical Care Medicine

ISSN

2220-3141

Publisher of This Article

Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

Retrospective Study

Copyright: ©Author(s) 2026. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution-NonCommercial (CC BY-NC 4.0) license. No commercial re-use. See permissions. Published by Baishideng Publishing Group Inc.

World J Crit Care Med. Sep 9, 2026; 15(3): 115627
Published online Sep 9, 2026. doi: 10.5492/wjccm.115627

Table 1 Clinical characteristics, management, and outcome in traumatic brain injury based on pulse pressure (n = 5029), n (%)/mean ± SD

	PP ≤ 30 mmHg	PP: 31-40 mmHg	PP: 41-50 mmHg	PP: 51-60 mmHg	PP > 60 mmHg	P value
Number (n = 4963)	578 (11.5)	1010 (20.1)	1409 (28.0)	1102 (21.9)	930 (18.5)
Age (yr)	28.7 ± 16.2	28.4 ± 14.7	29.1 ± 15.0	31.2 ± 15.3	36.5 ± 19.6	0.001
Males	517 (89.4)	910 (90.1)	1276 (90.6)	1023 (92.8)	857 (92.2)	0.05 for all
Females	61 (10.6)	100 (9.9)	133 (9.4)	79 (7.2)	73 (7.8)	0.05 for all
Mechanism of injury
Traffic-related	238 (41.2)	359 (35.5)	499 (35.4)	387 (35.1)	376 (40.4)	0.001 for all
Pedestrians	114 (19.7)	155 (15.3)	195 (13.8)	144 (13.1)	121 (13.0)
Fall from height	166 (28.7)	348 (34.5)	523 (37.1)	419 (38.0)	317 (34.1)
Fall of a heavy object	14 (2.4)	52 (5.1)	71 (5.0)	66 (6.0)	46 (4.9)
Others	46 (8.0)	96 (9.5)	121 (8.6)	86 (7.8)	70 (7.5)
Vitals at scene
Pulse (n = 3718)	101.2 ± 27.0	94.9 ± 24.2	93.4 ± 23.4	89.1 ± 20.8	90.4 ± 21.8	0.001
SBP (n = 3618)	126.0 ± 27.6	129.9 ± 23.3	130.3 ± 21.9	135.4 ± 20.9	143.9 ± 27.7	0.001
DBP (n = 3606)	82.2 ± 22.2	81.1 ± 20.6	81.8 ± 16.8	83.6 ± 17.6	86.2 ± 18.6	0.001
GCS (mean, 95%CI) (n = 3794)	10.0 (9.6-10.5)	11.4 (11.1-11.7)	12.4 (12.1-12.6)	12.7 (12.4-12.9)	12.3 (11.9-12.6)	0.001
Vital signs at hospital admission (ED)
Pulse	107.1 ± 26.8	97.5 ± 24.5	93.5 ± 22.3	90.2 ± 20.6	91.2 ± 22.1	0.001
SBP	100.7 ± 22.6	113.7 ± 15.8	123.2 ± 14.7	133.1 ± 14.2	151.2 ± 22.3	0.001
DBP	76.2 ± 22.2	76.3 ± 15.8	76.5 ± 14.3	77.0 ± 13.6	77.0 ± 16.9	0.733
GCS (mean, 95%CI) (n = 4931)	8.4 (7.8-8.9)	10.3 (9.9-10.7)	11.3 (11.0-11.6)	11.9 (11.5-12.2)	11.3 (10.9-11.7)	0.001
Shock index in the ED	1.15 ± 0.49	0.88 ± 0.29	0.77 ± 0.22	0.69 ± 0.18	0.62 ± 0.18	0.001
Ethanol levels	41.4 ± 21.9	41.5 ± 22.2	43.2 ± 19.7	40.0 ± 24.9	39.0 ± 23.7	0.79
Ethanol positive	55 (9.5)	110 (10.9)	124 (8.8)	77 (7.0)	51 (5.5)	0.001
MAP in the ED	84.4 ± 22.2	88.8 ± 15.8	92.1 ± 14.3	95.7 ± 13.7	101.7 ± 17.9	0.001
Associated injuries
Chest	282 (48.8)	343 (34.0)	389 (27.6)	264 (24.0)	265 (28.5)	0.001
Abdomen	167 (28.9)	193 (19.1)	166 (11.8)	102 (9.3)	55 (5.9)	0.001
Pelvis	110 (19.0)	122 (12.1)	113 (8.0)	74 (6.7)	57 (6.1)	0.001
Lower extremity	121 (20.9)	158 (15.6)	170 (12.1)	125 (11.3)	93 (10.0)	0.001
Upper extremity	182 (31.5)	221 (21.9)	298 (21.1)	200 (18.1)	207 (22.3)	0.001
Acute kidney injury	25 (4.3)	21 (2.1)	15 (1.1)	9 (0.8)	15 (1.6)	0.001
Head AIS score	3.6 ± 1.0	3.4 ± 0.9	3.3 ± 0.9	3.3 ± 0.9	3.4 ± 0.9	0.001
Chest AIS score	2.8 ± 0.7	2.7 ± 0.7	2.7 ± 0.6	2.6 ± 0.7	2.5 ± 0.7	0.001
Abdomen AIS score	2.7 ± 0.9	2.5 ± 0.9	2.4 ± 0.8	2.3 ± 0.8	2.3 ± 0.9	0.001
Pelvis AIS score	2.3 ± 0.8	2.2 ± 0.6	2.1 ± 0.4	2.1 ± 0.3	2.1 ± 0.3	0.004
MAP = SBP + 2 (DBP)/3, PP = SBP-DBP; SI = HR/SBP

PP: Pulse pressure; SBP: Systolic blood pressure; DBP: Diastolic blood pressure; GCS: Glasgow Coma Scale; CI: Confidence intervals; ED: Emergency department; MAP: Mean arterial pressure; AIS: Abbreviated Injury Scale; SI: Shock index; HR: Heart rate.

Full Size Table

Table 2 Management, complications, and outcome of traumatic brain injury patients across pulse pressure groups, n (%)/mean, 95% confidence intervals

	PP ≤ 30 mmHg	PP: 31-40 mmHg	PP: 41-50 mmHg	PP: 51-60 mmHg	PP > 60 mmHg	P value
Number	578 (11.5)	1010 (20.1)	1409 (28.0)	1102 (21.9)	930 (18.5)
Injury Severity Score (n = 5016), mean ± SD	24.7 ± 12.0	19.7 ± 10.9	18.1 ± 10.0	17.5 ± 9.0	18.3 ± 9.2	0.001
Intubation	358 (61.9)	414 (41.0)	461 (32.7)	337 (30.6)	355 (38.2)	0.001
Exploratory laparotomy	60 (10.4)	54 (5.3)	35 (2.5)	20 (1.8)	7 (0.8)	0.001
Craniotomy/craniectomy	63 (10.9)	92 (9.1)	153 (10.9)	110 (10.0)	116 (12.5)	0.17
Blood transfusion	303 (52.4)	287 (28.4)	292 (20.7)	173 (15.7)	175 (18.8)	0.001
Blood units transfused	6 (1-79)	4 (1-49)	3 (1-62)	3 (1-20)	4 (1-51)	0.001
Massive transfusion protocol activation	117 (20.2)	73 (7.2)	43 (3.1)	17 (1.5)	17 (1.8)	0.001
ARDS	21 (3.6)	11 (1.1)	13 (0.9)	11 (1.0)	11 (1.2)	0.001
Intensive care unit length of stay	7 (1-115)	5 (1-155)	5 (1-161)	5 (1-70)	5 (1-126)	0.001
Ventilator days	6 (1-115)	6 (1-180)	5 (1-55)	5 (1-84)	6 (1-100)	0.15
Hospital length of stay (days; n = 5010)	10 (1-304)	7 (1-360)	6 (1-217)	6 (1-218)	8 (1-186)	0.001
In-hospital mortality	139 (24.0)	96 (9.5)	77 (5.5)	65 (5.9)	67 (7.2)	0.001

PP: Pulse pressure; ARDS: Acute respiratory distress syndrome.

Full Size Table

Table 3 Bivariate correlation between pulse pressure and other relevant factors

Variables	Pearson correlation	P value
Age	0.210	0.001
Shock index in the ED	-0.474	0.001
MAP in the ED	0.346	0.001
Injury Severity Score	-0.115	0.001
Glasgow Coma Scale score	0.098	0.001
Blood transfusion units	-0.184	0.001

ED: Emergency department; MAP: Mean arterial pressure.

Full Size Table

Table 4 Multivariable logistic regression analysis of predictors of mortality

Variable	Adjusted odd ratio	95% confidence interval	P value
Age	1.022	1.012-1.032	0.001
Sex (male)	1.364	0.796-2.337	0.259
Head AIS¹	2.757	2.307-3.295	0.001
Pulse pressure at TRU¹	0.986	0.978-0.994	0.001
Blood transfusion units	1.061	1.037-1.084	0.001
ARDS	2.781	1.533-5.044	0.001

¹Continuous variable.

AIS: Abbreviated Injury Scale; TRU: Triage and reception unit; ARDS: Acute respiratory distress syndrome.

Full Size Table

Citation: Ahmed K, El-Menyar A, Asim M, Al Jogol H, Taha I, Kanbar A, Younis B, Rizoli S, Al-Thani H. Prognostic utility of on-admission pulse pressure in hospitalized patients with traumatic brain injury. World J Crit Care Med 2026; 15(3): 115627
URL: https://www.wjgnet.com/2220-3141/full/v15/i3/115627.htm
DOI: https://dx.doi.org/10.5492/wjccm.115627

Ahmed K, El-Menyar A, Asim M, Al Jogol H, Taha I, Kanbar A, Younis B, Rizoli S, Al-Thani H. Prognostic utility of on-admission pulse pressure in hospitalized patients with traumatic brain injury. World J Crit Care Med 2026; 15(3): 115627 [DOI: 10.5492/wjccm.115627]

All content on this site: Copyright © 1993-2026 Baishideng Publishing Group Inc, its licensors, and contributors. All rights are reserved, including those for text and data mining, AI training, and similar technologies. For all open access content, the relevant licensing terms apply.