Echocardiogram utilization in hospitalized adults with isolated traumatic brain injury: Propensity-matched analysis of the national inpatient sample 2016–2020

Abstract

Background: Early left ventricular systolic dysfunction is common after moderate-severe traumatic brain injury (TBI). Echocardiography (Echo) can evaluate cardiac function across various clinical scenarios; however, its utilization in isolated TBI remains poorly understood. To address this gap, we aim to examine Echo utilization in hospitalized adults with isolated TBI. Methods: Using a propensity-matched cohort based on All Patient Refined Diagnosis Related Group severity of illness, we performed a multivariable logistic regression analysis (adjusting for demographics, admitting hospital characteristics, TBI characteristics, cardiac comorbidities, and cardiac complications) to examine factors associated with Echo utilization in patients with isolated TBI in the US National Inpatient Sample (2016–2020). We reported adjusted odds ratio (aOR) and 95% confidence intervals. Results: In 4874 patients matched by APR-DRG severity of illness, the factors associated with Echo utilization were as follows: Older age compared to 18–44 years, Urban teaching hospital: aOR 1.44 [1.05;1.98], TBI associated with syncope: 3.29 [2.68;4.07], ICP monitoring: 2.26 [1.18, 4.45), hypertension: 1.35 [1.18, 1.54], myocardial infarction: 2.89 [2.14, 3.94], atrial fibrillation:1.38 [1.10, 1.74], heart failure: 1.57 [1.31, 1.87], ventricular tachycardia: 1.85 [1.28, 2.71), and pulmonary embolism: 2.61 [1.51, 4.66]. Conclusions: Echo utilization was associated with TBI etiology, pre-existing cardiac comorbidities, and in-hospital cardiac complications. These findings need validation in prospective studies.