title: Measurement of intracranial pressure and short-term outcomes of patients with traumatic brain injury: a propensity-matched analysis.
abstract: OBJECTIVE
  To assess the impact of intracranial pressure monitoring on the short-term outcomes of traumatic brain injury patients.
  
  
  METHODS
  Retrospective observational study including 299 consecutive patients admitted due to traumatic brain injury from January 2011 through July 2012 at a Level 1 trauma center in São Paulo, Brazil. Patients were categorized in two groups according to the measurement of intracranial pressure (measured intracranial pressure and non-measured intracranial pressure groups). We applied a propensity-matched analysis to adjust for possible confounders (variables contained in the Crash Score prognostic algorithm).
  
  
  RESULTS
  Global mortality at 14 days (16%) was equal to that observed in high-income countries in the CRASH Study and was better than expected based on the CRASH calculator score (20.6%), with a standardized mortality ratio of 0.77. A total of 28 patients received intracranial pressure monitoring (measured intracranial pressure group), of whom 26 were paired in a 1:1 fashion with patients from the non-measured intracranial pressure group. There was no improvement in the measured intracranial pressure group compared to the non-measured intracranial pressure group regarding hospital mortality, 14-day mortality, or combined hospital and chronic care facility mortality. Survival up to 14 days was also similar between groups.
  
  
  CONCLUSIONS
  Patients receiving intracranial pressure monitoring tend to have more severe traumatic brain injuries. However, after adjusting for multiple confounders using propensity scoring, no benefits in terms of survival were observed among intracranial pressure-monitored patients and those managed with a systematic clinical protocol.
authors.affiliation: Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil.
authors.forename: Cesar Biselli
authors.initials: CB
authors.lastname: Ferreira
authors.affiliation: Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil.
authors.forename: Estevão
authors.initials: E
authors.lastname: Bassi
authors.affiliation: Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil.
authors.forename: Lucas
authors.initials: L
authors.lastname: Lucena
authors.affiliation: Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil.
authors.forename: Hernandez
authors.initials: H
authors.lastname: Carreta
authors.affiliation: Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil.
authors.forename: Leandro Costa
authors.initials: LC
authors.lastname: Miranda
authors.affiliation: Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil.
authors.forename: Paulo Fernando Guimarães Mazorcchi
authors.initials: PF
authors.lastname: Tierno
authors.affiliation: Universidade de São Paulo, São Paulo, SP, Brazil.
authors.forename: Robson Luis
authors.initials: RL
authors.lastname: Amorim
authors.affiliation: Unidade de Terapia Intensiva, Hospital Alemão Oswaldo Cruz, São Paulo, SP, Brazil.
authors.forename: Fernando Godinho
authors.initials: FG
authors.lastname: Zampieri
authors.affiliation: Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil.
authors.forename: Luis Marcelo Sá
authors.initials: LM
authors.lastname: Malbouisson
mesh_terms: D000328:Adult; D000070642:Brain Injuries, Traumatic / Q000150:complications* / Q000401:mortality; D001938:Brazil; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D015601:Injury Severity Score; D007427:Intracranial Pressure; D008297:Male; D008875:Middle Aged; D008991:Monitoring, Physiologic / Q000379:methods*; D057216:Propensity Score; D012189:Retrospective Studies; D015996:Survival Rate; D016896:Treatment Outcome; D055815:Young Adult