Signal Information Prediction of Mortality Identifies Unique Patient Subsets after Severe Traumatic Brain Injury: A Decision-Tree Analysis Approach

Gao, Lei; Smielewski, Peter; P, Li; Czosnyka, Marek; Ercole, Ari

doi:10.1089/neu.2019.6631

Cited by 13 publications

(6 citation statements)

References 47 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In fact, complex temporal patterns including fractal patterns have been observed in many physiological signals 7–9 such as gait, 10 mobility, 11 motor function, 12 and activity patterns, 4,5 all of which have been linked to AD and pathology 13–16 . It has been accepted that fractal patterns are generated by multiple such processes in an ongoing feedback loop 7 .…”

Section: Introductionmentioning

confidence: 99%

Fractal motor activity regulation and sex differences in preclinical Alzheimer's disease pathology

Gao

Gaba

Musiek³

et al. 2021

Alz & Dem Diag Ass & Dis Mo

Self Cite

View full text Add to dashboard Cite

Introduction Degradation in fractal motor activity regulation (FMAR), a measure of multiscale self‐similarity of motor control, occurs in aging and accelerates with clinical progression to Alzheimer's disease (AD). Whether FMAR changes occur during the pre‐symptomatic phase of the disease in women and men remains unknown. Methods FMAR was assessed in cognitively normal participants (n = 178) who underwent 7 to 14 days of home actigraphy. Preclinical AD pathology was determined by amyloid imaging‐Pittsburgh compound B (PiB) and cerebrospinal fluid (CSF) phosphorylated‐tau181 (p‐tau) to amyloid beta 42 (Aβ42) ratio. Results Degradation in daytime FMAR was overall significantly associated with preclinical amyloid plaque pathology via PiB+ imaging (beta coefficient β = 0.217, standard error [SE] = 0.101, P = .034) and increasing CSF tau181‐Aβ42 ratio ( β = 0.220, SE = 0.084, P = .009). In subset analysis by sex, the effect sizes were significant in women for PiB+ ( β = 0.279, SE = 0.112, P = .015) and CSF ( β = 0.245, SE = 0.094, P = .011) but not in men (both P s > .05). These associations remained after inclusion of daily activity level, apolipoprotein E ε4 carrier status, and rest/activity patterns. Discussion Changes in daytime FMAR from actigraphy appear to be present in women early in preclinical AD. This may be a combination of earlier pathology changes in females reflected in daytime FMAR, and a relatively underpowered male group. Further studies are warranted to test FMAR as an early noncognitive physiological biomarker that precedes the onset of cognitive symptoms.

show abstract

Section: Introductionmentioning

confidence: 99%

Fractal motor activity regulation and sex differences in preclinical Alzheimer's disease pathology

Gao

Gaba

Musiek³

et al. 2021

Alz & Dem Diag Ass & Dis Mo

Self Cite

View full text Add to dashboard Cite

show abstract

“…The study concluded that age, Glasgow Coma Scale, fibrin/fibrinogen degradation products, and blood glucose were the most predictive factors of mortality amongst both TBI and elderly patients [22] . Abnormalities in these predictive criteria have been associated with inferior outcomes [23] , [24] . In this study, those who survived had significantly higher GCS scores (8.25 vs 5.63, P < 0.001).…”

Section: Discussionmentioning

confidence: 99%

“…Patients with lower CGS scores tend to have poorer neurologic exams. While the strengths of GCS include its ease to measure and reliability, the use of GCS is limited in sedated patients, patients intoxicated with alcohol or drugs, and patients with facial fractures [24] . Both IMPACT and CRASH models demonstrate the prognostic value in predicting mortality within two weeks and unfavorable outcomes utilizing factors such as GCS, pupil response, age, hypoxia, glucose, and even hypotension [25] .…”

Section: Discussionmentioning

confidence: 99%

The significant impact of Coronavirus disease 2019 (COVID-19) on in-hospital mortality of elderly patients with moderate to severe traumatic brain injury: A retrospective observational study

Bagheri

Abdi

Benson

et al. 2021

Journal of Clinical Neuroscience

View full text Add to dashboard Cite

Background Traumatic brain injury (TBI) is one of the main causes of death and disability among the elderly patient population. This study aimed to assess the predictors of in-hospital mortality of elderly patients with moderate to severe TBI who presented during the Coronavirus disease 2019 (COVID-19) pandemic. Methods In this retrospective analytical study, all elderly patients with moderate to severe TBI who were referred to our center between March 2nd, 2020 to August 1st, 2020 were investigated and compared against the TBI patients receiving treatment during the same time period within the year 2019. Patients were followed until discharge from the hospital or death. The demographic, clinical, radiological, and laboratory test data were evaluated. Data were analyzed using SPSS-21 software. Findings In this study, 359 elderly patients were evaluated ( n = 162, Post-COVID-19). Fifty-four patients of the cohort had COVID-19 disease with a mortality rate was 33.3%. The patients with COVID-19 were 5.45 times more likely to expire before discharge (P < 0.001) than the TBI patients who were not COVID-19 positive. Other variables such as hypotension (OR, 4.57P < 0.001), hyperglycemia (OR, 2.39, P = 0.002), and use of anticoagulant drugs (OR, 2.41P = 0.001) were also associated with in-hospital death. According to the binary logistic regression analysis Age (OR, 1.72; 95% CI: 1.26–2.18; P = 0.033), Coronavirus infection (OR, 2.21; 95% CI: 1.83–2.92; P = 0.011) and Glasgow Coma Scale (GCS) (OR, 3.11; 95% CI: 2.12–4.53; P < 0.001) were independent risk factors correlated with increased risk of in-hospital mortality of elderly patients with moderate to severe TBI. Conclusion Our results showed that Coronavirus infection could increase the risk of in-hospital mortality of elderly patients with moderate to severe TBI significantly.

show abstract

“…The majority of this cohort were elderly women due to the age group and voluntary nature of participation; this limits generalizability to a more general or younger population. Quantitative methods have recently been sought to best characterize physiological data, [30][31][32][33][34] including sleep behaviour. 35,36 The challenge has always been to extract meaningful and physiologically relevant insight into the underlying biological trait of interest.…”

Section: Discussionmentioning

confidence: 99%

<p>Fragmentation of Rest/Activity Patterns in Community-Based Elderly Individuals Predicts Incident Heart Failure</p>

Gao¹,

Lim²,

Wong³

et al. 2020

NSS

Self Cite

View full text Add to dashboard Cite

Study Objectives: Heart failure has previously been linked to sleep disorders that are often associated with frequent disturbances to human rest/activity patterns. We tested whether fragmentation of sustained rest/activity patterns derived from actigraphic recordings at baseline predicts incident heart failure in community-based elderly individuals. Methods: We studied 1099 community-based elderly adults participating in the Rush Memory and Aging Project who had baseline motor activity monitoring up to 11 days and were followed annually for up to 14 years. Fragmentation was assessed using previously validated indexes, derived from the probability of transitions once sustained rest or activity has been established. Heart failure was recorded via a clinical interview during the annual follow-up. Cox proportional hazards models were constructed to examine the relationship between rest fragmentation index and incident heart failure. Covariates grouped in terms of demographics, lifestyle factors and co-morbidities and cardiovascular risk factors/diseases were included. Results: Increased rest fragmentation (but not activity fragmentation) was associated with higher risk for incident heart failure. Specifically, a subject with a rest fragmentation at the 90th percentile showed a 57% increased risk of developing incident heart failure compared to a subject at the 10th percentile in this cohort. This effect was equivalent to that of being over a decade older. These observations were consistent after adjusting for all covariates. Conclusion: Increased rest fragmentation, a potential surrogate for sleep fragmentation, is independently associated with a higher risk of developing heart failure in community-based elderly adults during up to 14 years of follow-up. Further work is required to examine the specific contributions from daytime napping versus nighttime sleep periods in the elderly, as well as the underlying autonomic and cardio-dynamic pathways that may explain the effects on heart function.

show abstract

Signal Information Prediction of Mortality Identifies Unique Patient Subsets after Severe Traumatic Brain Injury: A Decision-Tree Analysis Approach

Cited by 13 publications

References 47 publications

Fractal motor activity regulation and sex differences in preclinical Alzheimer's disease pathology

Fractal motor activity regulation and sex differences in preclinical Alzheimer's disease pathology

The significant impact of Coronavirus disease 2019 (COVID-19) on in-hospital mortality of elderly patients with moderate to severe traumatic brain injury: A retrospective observational study

<p>Fragmentation of Rest/Activity Patterns in Community-Based Elderly Individuals Predicts Incident Heart Failure</p>

Contact Info

Product

Resources

About