The impact of intracranial pressure monitoring on mortality after severe traumatic brain injury.
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.
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.
Brian W
BW
MacLaughlin
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.
David S
DS
Plurad
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.
William
W
Sheppard
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.
Scott
S
Bricker
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.
Fred
F
Bongard
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.
Angela
A
Neville
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.
Jennifer A
JA
Smith
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.
Brant
B
Putnam
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.
Dennis Y
DY
Kim
D000328:Adult; D001930:Brain Injuries / Q000150:complications / Q000401:mortality* / Q000503:physiopathology*; D005260:Female; D015600:Glasgow Coma Scale; D017052:Hospital Mortality; D006801:Humans; D015601:Injury Severity Score; D007427:Intracranial Pressure / Q000502:physiology*; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D008991:Monitoring, Physiologic; D012189:Retrospective Studies; D015996:Survival Rate
Intracranial pressure monitor; Mortality; Outcomes; Severe; Traumatic brain injury