Correlation between intracranial pressure monitoring for severe traumatic brain injury with hospital length of stay and discharge disposition: a retrospective observational cohort study
Abstract Objectives Intracranial pressure (ICP) monitoring is recommended for severe traumatic brain injuries (TBI) but some data suggests it may not improve outcomes. The objective was to investigate the effect of ICP monitoring among TBI. Methods This retrospective observational cohort study (1/1/...
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| Format: | Article |
| Language: | English |
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BMC
2022-12-01
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| Series: | Patient Safety in Surgery |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s13037-022-00350-9 |
| _version_ | 1797973534376460288 |
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| author | Christopher W. Foote Stephanie Jarvis Xuan-Lan Doan Jordan Guice Bianca Cruz Cheryl Vanier Alejandro Betancourt David Bar-Or Carlos H. Palacio |
| author_facet | Christopher W. Foote Stephanie Jarvis Xuan-Lan Doan Jordan Guice Bianca Cruz Cheryl Vanier Alejandro Betancourt David Bar-Or Carlos H. Palacio |
| author_sort | Christopher W. Foote |
| collection | DOAJ |
| description | Abstract Objectives Intracranial pressure (ICP) monitoring is recommended for severe traumatic brain injuries (TBI) but some data suggests it may not improve outcomes. The objective was to investigate the effect of ICP monitoring among TBI. Methods This retrospective observational cohort study (1/1/2015–6/1/2020) included severe TBI patients. Outcomes [discharge destination, length of stay (LOS)] were compared by ICP monitoring and were stratified by GCS (3 vs. 4–8), α < 0.05. Results Of the123 patients who met inclusion criteria, 47% received ICP monitoring. There were baseline differences in the two groups characteristics, ICP monitored patients were younger (p = 0.02), had a subarachnoid hemorrhage less often (p = 0.04), and a subdural hematoma more often (p = 0.04) than those without ICP monitors. ICP monitored patients had a significantly longer median LOS (12 vs. 3, p < 0.01) than patients without monitoring. There was a trend towards more ICP monitored patients discharged home (40% vs. 23%, p = 0.06). Among patients with GCS = 3, ICP monitored patients had a longer LOS (p < 0.01) with no significant differences in discharge destinations. For those with a GCS of 4–8, ICP monitoring was associated with a longer LOS (p = 0.01), but fewer were discharged to a skilled nursing facility or long-term care (p = 0.01). Conclusions For TBI patients, ICP monitoring was associated with an increased LOS, with no significant differences in discharge destinations when compared to those without ICP monitoring. However, among only those with a GCS of 4–8, ICP monitoring was associated with a decreased proportion of patients discharged to a skilled nursing facility or long-term acute care . |
| first_indexed | 2024-04-11T04:05:39Z |
| format | Article |
| id | doaj.art-ce43c761996448178bd9a6c9af220622 |
| institution | Directory Open Access Journal |
| issn | 1754-9493 |
| language | English |
| last_indexed | 2024-04-11T04:05:39Z |
| publishDate | 2022-12-01 |
| publisher | BMC |
| record_format | Article |
| series | Patient Safety in Surgery |
| spelling | doaj.art-ce43c761996448178bd9a6c9af2206222023-01-01T12:25:13ZengBMCPatient Safety in Surgery1754-94932022-12-011611610.1186/s13037-022-00350-9Correlation between intracranial pressure monitoring for severe traumatic brain injury with hospital length of stay and discharge disposition: a retrospective observational cohort studyChristopher W. Foote0Stephanie Jarvis1Xuan-Lan Doan2Jordan Guice3Bianca Cruz4Cheryl Vanier5Alejandro Betancourt6David Bar-Or7Carlos H. Palacio8McAllen Medical Center, South Texas Health SystemInjury Outcomes Network (ION) ResearchMcAllen Medical Center, South Texas Health SystemBrooke Army Medical CenterMcAllen Medical Center, South Texas Health SystemTouro University, School of MedicineMcAllen Medical Center, South Texas Health SystemInjury Outcomes Network (ION) ResearchMcAllen Medical Center, South Texas Health SystemAbstract Objectives Intracranial pressure (ICP) monitoring is recommended for severe traumatic brain injuries (TBI) but some data suggests it may not improve outcomes. The objective was to investigate the effect of ICP monitoring among TBI. Methods This retrospective observational cohort study (1/1/2015–6/1/2020) included severe TBI patients. Outcomes [discharge destination, length of stay (LOS)] were compared by ICP monitoring and were stratified by GCS (3 vs. 4–8), α < 0.05. Results Of the123 patients who met inclusion criteria, 47% received ICP monitoring. There were baseline differences in the two groups characteristics, ICP monitored patients were younger (p = 0.02), had a subarachnoid hemorrhage less often (p = 0.04), and a subdural hematoma more often (p = 0.04) than those without ICP monitors. ICP monitored patients had a significantly longer median LOS (12 vs. 3, p < 0.01) than patients without monitoring. There was a trend towards more ICP monitored patients discharged home (40% vs. 23%, p = 0.06). Among patients with GCS = 3, ICP monitored patients had a longer LOS (p < 0.01) with no significant differences in discharge destinations. For those with a GCS of 4–8, ICP monitoring was associated with a longer LOS (p = 0.01), but fewer were discharged to a skilled nursing facility or long-term care (p = 0.01). Conclusions For TBI patients, ICP monitoring was associated with an increased LOS, with no significant differences in discharge destinations when compared to those without ICP monitoring. However, among only those with a GCS of 4–8, ICP monitoring was associated with a decreased proportion of patients discharged to a skilled nursing facility or long-term acute care .https://doi.org/10.1186/s13037-022-00350-9Traumatic brain injuryIntracranial hypertensionIntracranial pressure monitorGuideline |
| spellingShingle | Christopher W. Foote Stephanie Jarvis Xuan-Lan Doan Jordan Guice Bianca Cruz Cheryl Vanier Alejandro Betancourt David Bar-Or Carlos H. Palacio Correlation between intracranial pressure monitoring for severe traumatic brain injury with hospital length of stay and discharge disposition: a retrospective observational cohort study Patient Safety in Surgery Traumatic brain injury Intracranial hypertension Intracranial pressure monitor Guideline |
| title | Correlation between intracranial pressure monitoring for severe traumatic brain injury with hospital length of stay and discharge disposition: a retrospective observational cohort study |
| title_full | Correlation between intracranial pressure monitoring for severe traumatic brain injury with hospital length of stay and discharge disposition: a retrospective observational cohort study |
| title_fullStr | Correlation between intracranial pressure monitoring for severe traumatic brain injury with hospital length of stay and discharge disposition: a retrospective observational cohort study |
| title_full_unstemmed | Correlation between intracranial pressure monitoring for severe traumatic brain injury with hospital length of stay and discharge disposition: a retrospective observational cohort study |
| title_short | Correlation between intracranial pressure monitoring for severe traumatic brain injury with hospital length of stay and discharge disposition: a retrospective observational cohort study |
| title_sort | correlation between intracranial pressure monitoring for severe traumatic brain injury with hospital length of stay and discharge disposition a retrospective observational cohort study |
| topic | Traumatic brain injury Intracranial hypertension Intracranial pressure monitor Guideline |
| url | https://doi.org/10.1186/s13037-022-00350-9 |
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