Serum biomarkers for risk assessment of intrahospital transports in neurosurgical intensive care unit patients.

Abstract

BACKGROUND Intra-hospital transport (IHT) of neurosurgical intensive care (NICU) patients for cranial computed tomography (CCT) scans is associated with a high rate of complications. The potential of serum biomarkers to estimate the risk for complications associated with IHT and improve their safety remains underexplored. The present study investigated the influence of several serum biomarkers on IHT-associated complications in brain-injured NICU patients. METHODS A total of 523 IHTs in 223 NICU patients were prospectively analysed (05/2019-05/2020). Haemoglobin, haematocrit, serum sodium, and albumin levels were evaluated as serum biomarkers. Each patient's demographic data, cranial computed tomography (CCT) scan, NICU parameters and modified Rankin Scale at discharge as well as indications, consequences, and complications of IHTs were analysed. RESULTS In 58.7% of all IHTs, at least one IHT-associated complication was observed with 60.1% of all IHTs having no therapeutic consequence. Significantly lower rates of increased intracranial pressure (ICP; p<0.0001), decreased cerebral perfusion pressure (CPP; p=0.03) as well as hemodynamic (p<0.0001) and pulmonary events (p=0.01) were observed in patients with higher haemoglobin levels prior to IHT. Additionally, higher haematocrit levels before IHT were associated with a fewer rate of hemodynamic (p<0.0001), pulmonary (p=0.006), ICP (p<0.0001), and CPP (p=0.01) events. CONCLUSIONS Higher levels of haemoglobin and haematocrit are associated with less complications with respect to ICP, CPP, hemodynamic and pulmonary events during IHT in NICU patients. Therefore, these biomarkers may be helpful for risk assessment of potential complications prior to IHT.