Journal article
Intracranial Pressure Monitor Insertion in Isolated Traumatic Brain Injury: Does Timing Matter?
The American surgeon, v 91(11), pp 1845-1850
01 Aug 2025
PMID: 40747734
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
BackgroundIntracranial pressure monitoring (ICPM) is recommended in selected patients with severe traumatic brain injury (sTBI). Optimal timing of ICPM insertion after sTBI is not well studied. We aimed to evaluate if timing of ICPM insertion would impact outcomes.Materials and MethodsWe utilized data from 2018 to 2021 from the American College of Surgeons Trauma Quality Improvement Program. Patients ≥16 years from level 1 and 2 trauma centers with isolated blunt sTBI were included. Nonsurvivable brain injury (AIS-head = 6) and those needing emergent open cranial (OC) procedures within 2 hours of admission were excluded. Timing of ICPM insertion was categorized as follows: no ICPM insertion, ≤4 h, >4 to ≤12 h, and >12 h. Binary logistic regression analysis was used to assess variables associated with mortality.Results17 715 patients were included. 2525 (14%) had ICPM placed, 2613 (15%) underwent open cranial surgery, and 8757 (49%) died. There was no ICPM insertion in 86% while 8%, 4%, and 2% underwent ICPM insertion ≤4 h, >4 to ≤12 h, and >12 h, respectively. Compared to no ICPM, insertion ≤4 h (odds ratio [OR] 0.94 [0.82-1.09]), >4 to ≤12 h (OR 1.18 [0.97-1.43]), and >12 h (OR 1.02 [0.81-1.31]), respectively, were not associated with mortality. Open cranial procedure was associated with reduced risk of death (OR 0.40 [0.36-0.45]).DiscussionFor blunt isolated sTBI, Timing of ICPM insertion was not associated with mortality reduction. Early ICPM insertion may be less important than expeditious OC.
Metrics
4 Record Views
Details
- Title
- Intracranial Pressure Monitor Insertion in Isolated Traumatic Brain Injury: Does Timing Matter?
- Creators
- Michael D Gaziano - Division of Trauma and Critical Care, Department of Surgery, Reading Hospital, Reading, PA, USAPeter Aziz - Drexel University, SurgeryAlison Muller - Reading HospitalAnthony Martin - Reading HospitalH Christopher Lawson - Reading HospitalEugene F Reilly - Drexel University, SurgeryChristopher A Butts - Drexel University, SurgeryThomas A Geng - Reading HospitalAdrian W Ong - Drexel University, Surgery
- Publication Details
- The American surgeon, v 91(11), pp 1845-1850
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Surgery
- Web of Science ID
- WOS:001542289200001
- Scopus ID
- 2-s2.0-105017451012
- Other Identifier
- 991022065597804721
UN Sustainable Development Goals (SDGs)
This publication has contributed to the advancement of the following goals:
InCites Highlights
Data related to this publication, from InCites Benchmarking & Analytics tool:
- Web of Science research areas
- Surgery