A propensity score-matched cohort study of outcomes of paroxysmal sympathetic hyperactivity in persons with moderate to severe brain injury
10.3760/cma.j.cn421666-20241008-00819
- VernacularTitle:恢复期中重度脑损伤后阵发性交感神经兴奋综合征患者的预后结局分析
- Author:
Sujuan LIU
1
;
Yong WANG
1
;
Ran LI
1
;
Lu SONG
1
;
Haidong LI
1
;
Jie LIU
1
Author Information
1. 首都医科大学附属复兴医院康复中心，北京 邮编 100038
- Publication Type:Journal Article
- Keywords:
Paroxysmal sympathetic hyperactivity;
Hyperactivity;
Brain injury;
Prognosis
- From:
Chinese Journal of Physical Medicine and Rehabilitation
2025;47(7):608-613
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To evaluate the clinical outcomes of patients with paroxysmal sympathetic hyperactivity (PSH) after moderate to severe brain injury.Methods:Clinical data describing 580 patients of the Rehabilitation Center of Fuxing Hospital with moderate to severe brain injury were analyzed retrospectively. They were divided into a PSH group and a non-PSH group depending on whether PSH attacks occurred. Propensity score matching was performed to create a 1∶1 ratio between the two groups. The patients′ baseline characteristics were analyzed before the matching and with the matched cohorts, and the clinical outcomes of the patients in the matched cohorts were compared.Results:Seventy-five of the patients experienced PSH attacks and were included in the PSH group, while the others formed the non-PSH group. Before matching, the two groups had significant differences in age, atrial fibrillation, hypertension, chest trauma, Glasgow Coma Scale (GCS) score, tracheotomy, hydrocephalus, heart rate at admission, respiration rate, muscle tone, and limited joint activity. After the propensity score matching, 67 patients were included in the PSH and non-PSH groups. The differences in heart rate, respiration rate, muscle tone, and limited joint activity between the two groups at admission were then statistically significant. However, unlike the non-PSH group, the PSH group showed a significant decrease in its average GCS score and Glasgow Outcome Scale (GOS) score at discharge, as well as a significant increase in its average Disability Rating Scale score. Compared with the non-PSH group at the same time point, the GOS score of the PSH group had decreased by 0.47 at discharge ( CI: 0.41-0.56). Then, three months after discharge the average GOS score of the PSH group had decreased by 0.55 ( CI: 0.48-0.61. By six months that was 0.75 ( CI: 0.66-0.82) and by twelve months 0.87 ( CI: 0.77-0.97). Conclusions:PSH can affect the consciousness of patients with moderate to severe brain injury and their ability in the activities of daily life. The prognosis of PSH patients is relatively poor.
