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Accepted (AM)Open Access (License Unspecified), Open
Journal article
Frequency of and factors associated with emergency department intracranial pressure monitor placement in severe paediatric traumatic brain injury
Brain injury, v 31(13-14), pp 1745-1752
01 Jan 2017
PMID: 28829632
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
To examine the frequency of and factors associated with emergency department (ED) intracranial pressure (ICP) monitor placement in severe paediatric traumatic brain injury (TBI).
Retrospective, multicentre cohort study of children <18 years admitted to the ED with severe TBI and intubated for >48 hours from 2007 to 2011.
Two hundred and twenty-four children had severe TBI and 75% underwent either ED, operating room (OR) or paediatric intensive care unit (PICU) ICP monitor placement. Four out of five centres placed ICP monitors in the ED, mostly (83%) fibreoptic. Nearly 40% of the patients who received ICP monitors get it placed in the ED (29% overall). Factors associated with ED ICP monitor placement were as follows: age 13 to <18 year olds compared to infants (aRR 2.02; 95% CI 1.37, 2.98), longer ED length of stay (LOS) (aRR 1.15; 95% CI 1.08, 1.21), trauma centre designation paediatric only I/II compared to adult/paediatric I/II (aRR 1.71; 95% CI 1.48, 1.98) and higher mean paediatric TBI patient volume (aRR 1.88;95% CI 1.68, 2.11). Adjusted for centre, higher bedside ED staff was associated with longer ED LOS (aRR 2.10; 95% CI 1.06, 4.14).
ICP monitors are frequently placed in the ED at paediatric trauma centres caring for children with severe TBI. Both patient and organizational level factors are associated with ED ICP monitor placement.
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Details
- Title
- Frequency of and factors associated with emergency department intracranial pressure monitor placement in severe paediatric traumatic brain injury
- Creators
- Nithya Kannan - University of WashingtonAlex Quistberg - University of WashingtonJin Wang - University of WashingtonJonathan I Groner - The Ohio State UniversityRichard B Mink - The Lundquist InstituteMark S Wainwright - Lurie Children's HospitalMichael J Bell - University of PittsburghChristopher C Giza - Mattel Children's HospitalDouglas F Zatzick - University of WashingtonRichard G Ellenbogen - University of WashingtonLinda Ng Boyle - University of WashingtonPamela H Mitchell - University of WashingtonMonica S Vavilala - University of Washington
- Publication Details
- Brain injury, v 31(13-14), pp 1745-1752
- Publisher
- Taylor and Francis
- Grant note
- R01 NS072308 / NINDS NIH HHS
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Urban Health Collaborative; Environmental and Occupational Health
- Web of Science ID
- WOS:000416612500006
- Scopus ID
- 2-s2.0-85028539478
- Other Identifier
- 991021966369604721
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- Collaboration types
- Domestic collaboration
- Web of Science research areas
- Neurosciences
- Rehabilitation