World neurosurgery | 2019
First ICP monitoring or first operation:which one is better?.
Abstract
BACKGROUND\nFor traumatic brain injury patients,traditional methods such as clinical examination and imaging data are primarily reference for deciding operation or not.However,ICP monitoring based on lateral ventricles or parenchymal pressure is more direct to reflect the intracranial pressure. But recent studies have less research on whether the outcome of ICP-monitoring treatment has better effects than that based on clinical signs and imaging materials.Thus we compared treatment results for TBI patients based on monitoring of ICP and traditional methods.\n\n\nMETHODS\nTraumatic brain injury patients admitted to our collaborative hospitals from January 1,2012 to December 31,2013 were included to this retrospective study.All patients enrolled were divided into traditional methods group and ICP-monitoring group.The follow-up treatment was determined by ICP-monitoring value or experience in the two groups. A propensity matching scores were used to ensure that patients,s baseline characteristics in the two groups were consistent.\n\n\nRESULTS\nA significant association was found between the initial ICP and neurological deterioration(OR,1.24;P<0.001,) and nonlinear correlation achieved the best fit (R2= 0.547). Both the six-month good recovery rate and favorable outcome rate were higher in the ICP-monitoring group than the traditional methods group by propensity score analysis(P<0.05).\n\n\nCONCLUSIONS\nFor TBI patients with cerebral contusion volume of more than 20 ml, both the six-month good recovery rate and favorable outcome rate were higher in the ICP-monitoring group than the traditional methods group by propensity score analysis(P<0.05).