• Am. J. Surg. · Dec 2015

    The impact of intracranial pressure monitoring on mortality after severe traumatic brain injury.

    • Brian W MacLaughlin, David S Plurad, William Sheppard, Scott Bricker, Fred Bongard, Angela Neville, Jennifer A Smith, Brant Putnam, and Dennis Y Kim.
    • 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.
    • Am. J. Surg. 2015 Dec 1; 210 (6): 1082-6; discussion 1086-7.

    BackgroundThe 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.MethodsA 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.ResultsOf 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.ConclusionsICP 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.Copyright © 2015 Elsevier Inc. All rights reserved.

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