• Zhenxing Li, Jigang Chen, Danfeng Zhang, Liquan Lv, and Lijun Hou.
• Department of Neurosurgery, Changzheng Hospital, Second Military Medical University, Shanghai, China.
• World Neurosurg. 2019 Mar 1; 123: e156-e161.

BackgroundParoxysmal sympathetic hyperactivity (PSH) is an uncommon complication of severe traumatic brain injury (sTBI). The clinical risk factors for PSH have not been fully characterized, especially regarding tracheostomy, which has usually been recommended for patients with sTBI to facilitate treatment. We examined the effects of tracheostomy on PSH incidence in patients with sTBI.MethodsThe present single-center, retrospective study included consecutive patients with sTBI who had been admitted to the Shanghai Changzheng Hospital from January 1, 2013 to March 31, 2018. The potential risk factors related to the occurrence of PSH was explored by univariate analysis. Multivariate logistic regression analysis was conducted to determine the independence of the factors associated with PSH development.ResultsOf the 120 patients with sTBI, 17 with PSH were identified (14.16%). We found 3 risk factors were significantly associated with PSH on univariate and multivariate analyses: 1) tracheostomy (odds ratio [OR], 5.368; 95% confidence interval [CI], 1.102-26.151; P = 0.038); 2) age (OR, 0.916; 95% CI, 0.874-0.960; P < 0.001); and 3) hydrocephalus (OR, 6.715; 95% CI, 1.708-26.408; P = 0.006).ConclusionsOur results suggest that tracheostomy is independently associated with an increased incidence of PSH.Copyright © 2018. Published by Elsevier Inc.

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