Surgical and Trauma Intensive Care Unit, University Hospital of Reims, Reims Cedex, France.
University of Médecine, University of Reims Champagne-Ardenne, Reims Cedex, France.
Neurol Res. 2021 Apr;43(4):283-290. doi: 10.1080/01616412.2020.1849901. Epub 2020 Nov 19.
: To demonstrate that a BRASS score≥ 3 at admission of intubated, ventilated and sedated patients is predictive of mortality: we have realized an Observational prospective multicenter study.All Major patients without neurological history, admitted to ICU for a non-neurological cause, sedated and admitted under mechanical ventilation were included.: One hundred and ten patients were included, the BRASS score as well as the FOUR and RASS scores were collected.At day 28, patients with a BRASS score ≥ 3 had an excess mortality (OR 3.29 - CI 95% [1.42-7.63], p = 0.005) as well as day 90 (OR 2.65 - CI 95% [1.19-5.88], p = 0.02), without impact on the delirium measured by CAM-ICU (OR 1.8 - CI 95% [0.68-4.77], p = 0.023). After adjustment with SAPS II, FOUR and RASS, difference in mortality was not any more different.It is also noted that patients with BRASS ≥ 3 are more sedated (RASS: -5 [-5 - -5] vs -4 [-5 - -3], p < 0.0001) and more comatose (FOUR: 2 [1-4] vs 6 [4-9], p < 0.0001), and have higher doses of midazolam (10 mg/h [5-15] vs 7.5 mg/h [5-10], p = 0.02) and sufentanil (20 μg/h [15-22.5] vs 10 [10-12.5], p = 0.01).: The early alteration of brainstem reflexes measured by the BRASS score was not independently predictable in terms of mortality in the non-neurological ICU patients, admitted under sedation and mechanical ventilation.: ClinicalTrials.gov Identifier: NCT03835091,, .
: 为了证明入院时接受插管、通气和镇静治疗的患者的 BRASS 评分≥3 与死亡率相关：我们进行了一项观察性前瞻性多中心研究。所有无神经病史、因非神经原因入住 ICU、接受镇静治疗并接受机械通气的主要患者均被纳入研究。: 共纳入 110 例患者，收集 BRASS 评分以及 FOUR 和 RASS 评分。第 28 天，BRASS 评分≥3 的患者死亡率过高（OR 3.29-95%CI [1.42-7.63]，p=0.005），第 90 天死亡率同样过高（OR 2.65-95%CI [1.19-5.88]，p=0.02），但对 ICU 意识障碍评估（CAM-ICU）无影响（OR 1.8-95%CI [0.68-4.77]，p=0.023）。在与 SAPS II、FOUR 和 RASS 调整后，死亡率差异不再显著。还注意到，BRASS 评分≥3 的患者镇静程度更高（RASS：-5[-5--5] 与-4[-5--3]，p<0.0001），昏迷程度更高（FOUR：2[1-4] 与 6[4-9]，p<0.0001），咪达唑仑剂量更高（10mg/h[5-15] 与 7.5mg/h[5-10]，p=0.02）和舒芬太尼剂量更高（20μg/h[15-22.5] 与 10μg/h[10-12.5]，p=0.01）。: 在接受镇静和机械通气治疗的非神经 ICU 患者中，BRASS 评分测量的脑干反射早期改变与死亡率无关，不能独立预测。: ClinicalTrials.gov 标识符：NCT03835091，，。
