Journal article
Is Intracranial Pressure Monitoring After Open Cranial Procedures Associated With Outcome?
The Journal of surgical research, v 306, pp 344-349
Feb 2025
PMID: 39842048
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
It is unclear if intracranial pressure monitoring (ICPM) after open cranial procedures (craniotomy or craniectomy) (OC) for traumatic brain injury is associated with mortality. We hypothesized that ICPM placed early after OC was associated with lower mortality compared to no ICPM or delayed ICPM placement.
Using 2020-2021 data from the American College of Surgeons Trauma Quality Improvement Program, patients ≥ 16 years from level 1 and 2 trauma centers who underwent OC were divided into two groups: ICPM placed within 72 hours of OC (early) and no ICPM or ICPM placed after 72 hours (none/delayed). Outcome was in-hospital mortality. Logistic regression was used to elucidate predictors of mortality.
19830 patients (early ICPM, 29%) were included. Early patients were more likely to be from level 1 centers (63% vs 60%, p=0.004), younger (median age 47 vs 60, p<0.0001), to have a lower Glasgow Coma Score (GCS) (median, 6 vs 14, p<0.0001), higher Injury Severity Score (ISS) (median, 26 vs 26, p<0.0001), an unreactive pupil (33% vs 18%, p<0.0001), midline shift >5 mm (69% vs 60%, p<0.0001), received ≥2 units of blood/ first 4 hours (14% vs 6%, p<0.0001) and higher mortality (31% vs 19%, p<0.0001) compared to none/delayed patients. Controlled for significant variables, early ICPM was associated with increased mortality (odds ratio [OR] 1.35, 95% confidence interval [CI] 1.24-1.47). Analysis of subjects with isolated brain injury found a similar association (OR 1.32, 95% C1 1.15-1.52).
ICPM placed within 72 hours of OC was associated with increased mortality. Indications for ICPM after OC should be investigated further in multicenter prospective studies.
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Details
- Title
- Is Intracranial Pressure Monitoring After Open Cranial Procedures Associated With Outcome?
- Creators
- Peter Aziz - Drexel UniversityAlison Muller - Reading HospitalChristopher Butts - Reading HospitalEugene F. Reilly - Reading HospitalAnthony Martin - Reading HospitalChristopher Lawson - Reading HospitalThomas A. Geng - Reading HospitalAdrian W. Ong - Reading Hospital
- Publication Details
- The Journal of surgical research, v 306, pp 344-349
- Publisher
- Elsevier; SAN DIEGO
- Number of pages
- 6
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Surgery
- Web of Science ID
- WOS:001407610700001
- Scopus ID
- 2-s2.0-85215394453
- Other Identifier
- 991022020335904721
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- Web of Science research areas
- Surgery