V. Pandit1, A. Azim1, T. O’Keeffe1, A. Tang1, K. Ibraheem1, N. Kulvatunyou1, G. Vercruysse1, L. Gries1, B. Joseph1 1University Of Arizona,Trauma,critical Care, Burn And Emergency Surgery/Department Of Surgery,Tucson, AZ, USA
Introduction:
Brain Trauma Foundation (BTF) guidelines recommend intracranial pressure (ICP) monitoring for traumatic brain injury (TBI) patients; however their impact on patient outcomes in pediatric TBI patients remains unclear. The aim of this study was to assess outcomes in pediatric TBI patients meeting BTF guidelines for ICP monitoring. We hypothesized that ICP monitoring improve outcome after TBI
Methods:
The National Trauma Data Bank (2011-2012) was queried to include patients with isolated blunt TBI with age ≤18 years and Glasgow Coma Scale (GCS) score ≤9. Patients were stratified into two groups: ICP and No-ICP. Missing value analysis was performed after which patients in the two groups in a 1:2 ratio (ICP: No-ICP) were matched for age, gender, GCS, Head abbreviated injury scale (AIS), and admission vital parameters. Outcome measures were mortality, discharge disposition, hospital and ICU length of stay.
Results:
A total of 1106 patient met BTF criteria for ICP monitoring of which only 11.7% (n=130) patients received ICP. After propensity matching a total of 390 patients were included. Table 1.
Conclusion:
Our data suggests that use of ICP monitoring in pediatric TBI patients is low. Patients with ICP monitoring had higher mortality rate and worse outcomes compared to similar matched cohort of patients without ICP. This finding should provoke re-evaluation of the indication and utility of ICP monitoring in pediatric TBI patients
