Brian W MacLaughlin1, David S Plurad1, William Sheppard1, Scott Bricker1, Fred Bongard1, Angela Neville1, Jennifer A Smith1, Brant Putnam1, Dennis Y Kim2. 1. Division of Trauma/Acute Care Surgery/Surgical Critical Care, Department of Surgery, Harbor-UCLA Medical Center, 1000 West Carson Street, Box 42, Torrance, CA, 90509, USA. 2. Division of Trauma/Acute Care Surgery/Surgical Critical Care, Department of Surgery, Harbor-UCLA Medical Center, 1000 West Carson Street, Box 42, Torrance, CA, 90509, USA. Electronic address: dekim@dhs.lacounty.gov.
Abstract
BACKGROUND: The effect of intracranial pressure (ICP) monitoring on mortality after severe traumatic brain injury (sTBI) remains unclear. We hypothesized that ICP monitoring would not be associated with improved survival in patients with sTBI. METHODS: A retrospective analysis was performed on sTBI patients, defined as admission Glasgow Coma Scale score of 8 or less with intracranial hemorrhage. Patients who underwent ICP monitoring were compared with patients who did not. The primary outcome measure was inhospital mortality. RESULTS: Of 123 sTBI patients meeting inclusion criteria, 40 (32.5%) underwent ICP monitoring. On bivariate and multivariate regression analyses, ICP monitoring was associated with decreased mortality (odds ratio = .32, 95% confidence interval = .10 to .99, P = .049). This finding persisted on propensity-adjusted analysis. CONCLUSIONS: ICP monitoring is associated with improved survival in adult patients with sTBI. In addition, significant variability exists in the use of ICP monitoring among patients with sTBI.
BACKGROUND: The effect of intracranial pressure (ICP) monitoring on mortality after severe traumatic brain injury (sTBI) remains unclear. We hypothesized that ICP monitoring would not be associated with improved survival in patients with sTBI. METHODS: A retrospective analysis was performed on sTBI patients, defined as admission Glasgow Coma Scale score of 8 or less with intracranial hemorrhage. Patients who underwent ICP monitoring were compared with patients who did not. The primary outcome measure was inhospital mortality. RESULTS: Of 123 sTBI patients meeting inclusion criteria, 40 (32.5%) underwent ICP monitoring. On bivariate and multivariate regression analyses, ICP monitoring was associated with decreased mortality (odds ratio = .32, 95% confidence interval = .10 to .99, P = .049). This finding persisted on propensity-adjusted analysis. CONCLUSIONS: ICP monitoring is associated with improved survival in adult patients with sTBI. In addition, significant variability exists in the use of ICP monitoring among patients with sTBI.
Authors: Patrick T Delaplain; Areg Grigorian; Michael Lekawa; Michael Mallicote; Victor Joe; Sebastian D Schubl; Catherine M Kuza; Matthew Dolich; Jeffry Nahmias Journal: Pediatr Surg Int Date: 2020-01-14 Impact factor: 1.827
Authors: Mira Ghneim; Jennifer Albrecht; Karen Brasel; Ariel Knight; Anna Liveris; Jill Watras; Christopher P Michetti; James Haan; Kelly Lightwine; Robert D Winfield; Sasha D Adams; Jeanette Podbielski; Scott Armen; J Christopher Zacko; Fady S Nasrallah; Kathryn B Schaffer; Julie A Dunn; Brittany Smoot; Thomas J Schroeppel; Zachery Stillman; Zara Cooper; Deborah M Stein Journal: Trauma Surg Acute Care Open Date: 2021-07-23