Impact of Left Ventricular Systolic Function after Moderate to Severe Isolated Traumatic Brain Injury: A Systematic Review and Meta-Analysis.

Traumatic brain injury (TBI) can result in left ventricular (LV) dysfunction, which can lead to hypotension and secondary brain injuries. However, the associating between LV systolic dysfunction and in-hospital mortality in patients with moderate to severe isolated TBI is controversial. Therefore, we conducted a systematic review and meta-analysis to identify the prevalence of LV systolic dysfunction and evaluate whether LV systolic dysfunction following moderate to severe isolated TBI increases the in-hospital mortality. We searched PubMed, EMBASE, and Cochrane Library database from January 1st, 2010 through June 30th, 2020. Meta-analysis was performed to determine the incidence of LVSD and related mortality in patients with moderate-severe isolated TBI. A systematic review identified five articles appropriate for meta-analysis. The total number of patients pooled was 256. LVSD was reported in four studies, of which the estimated incidence of patients with LVSD was 18.7% (95% confidence interval (CI) 11.9 to 26.6). Five studies reported on in-hospital mortality, and the estimated in-hospital mortality was 14.1% (95% CI 5.3 to 25.6). Finally, three studies were eligible for analyzing the association of LVSD and in-hospital mortality. On meta-analysis, in-hospital mortality was significantly higher in patients with LVSD (risk ratio 6.57: 95% CI 3.71 to 11.65, p<0.001). In conclusion, LV systolic dysfunction after moderate to severe TBI is common and may be associated with worse in-hospital outcomes. Supplemental Digital Content; http://links.lww.com/CIR/A33.