Research Reports - The impact of intracranial pressure monitoring on mortality after severe traumatic brain injury

Am J Surg. 2015 Sep 18. pii: S0002-9610(15)00483-3. doi:
10.1016/j.amjsurg.2015.08.007. [Epub ahead of print]

MacLaughlin BW(1), Plurad DS(1), Sheppard W(1), Bricker S(1), Bongard F(1),
Neville A(1), Smith JA(1), Putnam B(1), Kim DY(2).

Author information:
(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.

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. 

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