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01.03.2020 | Original Article

Intracranial pressure monitoring associated with increased mortality in pediatric brain injuries

verfasst von: Patrick T. Delaplain, Areg Grigorian, Michael Lekawa, Michael Mallicote, Victor Joe, Sebastian D. Schubl, Catherine M. Kuza, Matthew Dolich, Jeffry Nahmias

Erschienen in: Pediatric Surgery International | Ausgabe 3/2020

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Abstract

Background

Utilization of ICP monitors for pediatric patients is low and varies between centers. We hypothesized that in more severely injured patients (GCS 3–4), there would be a decreased mortality associated with invasive monitoring devices.

Methods

The pediatric Trauma Quality Improvement Program (TQIP) was queried for patients aged ≤ 16 years meeting criteria for invasive monitors. Our primary outcome was mortality. Patients with ICP monitoring were compared to those without. A logistic regression was used to examine the risk of mortality.

Results

Of 3,808 patients, 685 (18.0%) underwent ICP monitoring. ICP monitors were associated with increased risk of mortality (OR 1.82, CI 1.36–2.44, p < 0.001). A secondary analysis including type of invasive ICP monitor and dividing GCS into 3 categories revealed both intraventricular drain (OR 1.89, CI 1.3–2.7, p = 0.001) and intraparenchymal pressure monitor (OR 1.86, CI 1.32–2.6, p < 0.001) to be independently associated with an increased likelihood of mortality regardless of GCS, while intraparenchymal oxygen monitoring was not (OR 0.47, CI 0.11–2.05, p = 0.316). The strongest effect was seen in those patients with a GCS of 5–6.

Conclusion

ICP monitors are an independent risk factor for mortality, particularly with intraventricular drains and intraparenchymal monitors in patients with a GCS 5–6.

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Titel: Intracranial pressure monitoring associated with increased mortality in pediatric brain injuries
verfasst von: Patrick T. Delaplain
Areg Grigorian
Michael Lekawa
Michael Mallicote
Victor Joe
Sebastian D. Schubl
Catherine M. Kuza
Matthew Dolich
Jeffry Nahmias
Publikationsdatum: 01.03.2020
Verlag: Springer Berlin Heidelberg
Erschienen in: Pediatric Surgery International / Ausgabe 3/2020
Print ISSN: 0179-0358
Elektronische ISSN: 1437-9813
DOI: https://doi.org/10.1007/s00383-020-04618-y

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Intracranial pressure monitoring associated with increased mortality in pediatric brain injuries

Abstract

Background

Methods

Results

Conclusion

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