Correlation analysis of basic vital signs and behavioral score of disorders of consciousness in patients with brainstem hemorrhage

Abstract

Objective To study the correlation of basic vital signs with behavioral score of disorders of consciousness (DOC) in patients with brainstem hemorrhage. Methods A total of 73 patients with brain stem hemorrhage were screened out from 375 patients admitted to the Department of Neurosurgery of the Second Affiliated Hospital of Army Medical University from January 2015 to November 2020. According to the Glasgow Coma Scale (GCS) score within 24 h after admission, they were divided into normal consciousness group (n=38) and severe DOC group (n=35). Their GCS score, GCS response ability, behavioral cognitive ability, limb response to pain stimulation and eye-opening response, as well as axillary temperature, pulse rate and respiratory rate were compared between the 2 groups at the 2 time points, that is, 24 h after admission and 24 h before discharge. According to the behavioral responses mentioned above, the patients out of severe DOC group were further assigned into the subgroup having behavioral responses (behavioral subgroup, n=21) and the subgroup without (non-behavioral subgroup, n=14), and the changes of axillary temperature, pulse rate and respiratory rate were compared with between them. The correlations and differences among the GCS scores and axillary body temperature, pulse rate and respiratory rate were analyzed between the normal consciousness group and the severe DOC group during the 24 h after admission and 24 h before discharge. Results In 24 h after admission and 24 h before discharge, the patients in the severe DOC group had significantly lower GCS scores and higher mean temperature and pulse rate than the normal consciousness group (P 0.05), and the rate within 24 h before discharge was obviously higher in the severe DOC group than another group (P 0.05). There were no significant differences in the mean value of axillary temperature, pulse rate and respiratory rate within 24 h after admission between the behavioral and non-behavioral subgroups (P>0.05), but the mean pulse rate within 24 h before discharge in the latter subgroup was significantly higher than that in the behavioral subgroups (P < 0.05). Conclusion The basic vital signs of patients with brainstem hemorrhage are closely correlated with the behavioral GCS scores of DOC, and among these signs, increased axillary temperature and pulse rate within 24 h after admission and 24 h before discharge are positively correlated with decreased GCS scores of patients with severe DOC.

Keywords

• brain stem hemorrhage
• basic vital signs
• disorders of consciousness
• behavioral assessment
• correlation