title: Effects of Intracranial Pressure Monitoring on Mortality in Patients with Severe Traumatic Brain Injury: A Meta-Analysis.
abstract: BACKGROUND
  The Brain Trauma Foundation (BTF) guidelines published in 2007 suggest some indications for intracranial pressure (ICP) monitoring in severe traumatic brain injury (TBI). However, some studies had not shown clinical benefit in patients with severe TBI; several studies had even reported that ICP monitoring was associated with an increased mortality rate. The effect of ICP monitoring has remained controversial, regardless of the ICP monitoring guidelines. Here we performed a meta-analysis of published studies to assess the effects of ICP monitoring in patients with severe TBI.
  
  
  METHODS
  We searched three comprehensive databases, the Cochrane Library, PUBMED, and EMBASE, for studies without limitations published up to September 2015. Mortality, ICU LOS, and hospital LOS were analyzed with Review Manager software according to data from the included studies.
  
  
  RESULTS
  Eighteen eligible studies involving 25229 patients with severe TBI were included in our meta-analysis. The results indicated no significant reduction in the ICP monitored group in mortality (hospitalized before 2007), hospital mortality (hospitalized before 2007), mortality in randomized controlled trials. However, overall mortality, mortality (hospitalized after 2007), hospital mortality (hospitalized after 2007), mortality in observational studies (hospitalized after 2007), 2-week mortality, 6-month mortality, were reduced in ICP monitored group. Patients with an increased ICP were more likely to require ICP monitoring.
  
  
  CONCLUSIONS
  Superior survival was observed in severe TBI patients with ICP monitoring since the third edition of "Guidelines for the Management of Severe Traumatic Brain Injury," which included "Indications for intracranial pressure monitoring," was published in 2007.
authors.affiliation: Department of Neurosurgery, Huzhou Central Hospital, Huzhou, Zhejiang, China.
authors.forename: Liang
authors.initials: L
authors.lastname: Shen
authors.affiliation: Department of Medical College, Nursing College of Huzhou University, Huzhou, Zhejiang, China.
authors.forename: Zhuo
authors.initials: Z
authors.lastname: Wang
authors.affiliation: Department of Neurosurgery, Huzhou Central Hospital, Huzhou, Zhejiang, China.
authors.forename: Zhongzhou
authors.initials: Z
authors.lastname: Su
authors.affiliation: Department of Neurosurgery, Huzhou Central Hospital, Huzhou, Zhejiang, China.
authors.forename: Sheng
authors.initials: S
authors.lastname: Qiu
authors.affiliation: Department of Neurosurgery, Huzhou Central Hospital, Huzhou, Zhejiang, China.
authors.forename: Jie
authors.initials: J
authors.lastname: Xu
authors.affiliation: Department of Neurosurgery, Huzhou Central Hospital, Huzhou, Zhejiang, China.
authors.forename: Yue
authors.initials: Y
authors.lastname: Zhou
authors.affiliation: Department of Neurosurgery, Huzhou Central Hospital, Huzhou, Zhejiang, China.
authors.forename: Ai
authors.initials: A
authors.lastname: Yan
authors.affiliation: Department of Neurosurgery, Huzhou Central Hospital, Huzhou, Zhejiang, China.
authors.forename: Rui
authors.initials: R
authors.lastname: Yin
authors.affiliation: Department of Neurosurgery, Huzhou Central Hospital, Huzhou, Zhejiang, China.
authors.forename: Bin
authors.initials: B
authors.lastname: Lu
authors.affiliation: Department of Neurosurgery, Huzhou Central Hospital, Huzhou, Zhejiang, China.
authors.forename: Xiaohu
authors.initials: X
authors.lastname: Nie
authors.affiliation: Department of Neurosurgery, Huzhou Central Hospital, Huzhou, Zhejiang, China.
authors.forename: Shufa
authors.initials: S
authors.lastname: Zhao
authors.affiliation: Department of Neurosurgery, Huzhou Central Hospital, Huzhou, Zhejiang, China.
authors.forename: Renfu
authors.initials: R
authors.lastname: Yan
mesh_terms: D000070642:Brain Injuries, Traumatic / Q000401:mortality* / Q000503:physiopathology; D003422:Critical Care; D017052:Hospital Mortality; D006801:Humans; D007427:Intracranial Pressure / Q000502:physiology*; D007902:Length of Stay / Q000706:statistics & numerical data*; D008991:Monitoring, Physiologic / Q000379:methods*; D015996:Survival Rate; D016896:Treatment Outcome